Prognostic value of combined response markers among human immunodeficiency virus-infected persons: Possible aid in the decision to change zidovudine monotherapy

Neil M H Graham, Lawrence P. Park, Steven Piantadosi, John P. Phair, John Mellors, John L. Fahey, Alfred J. Saah

    Research output: Contribution to journalArticle

    Abstract

    To clarify useful clinical parameters for determining the need for changes in antiretroviral regimens, 586 persons who were seropositive for the human immunodeficiency virus (HIV) and who had intermediate-stage HIV disease underwent follow-up semiannually for a median of 3.1 years after zidovudine monotherapy was instituted. The strongest predictors of time to the development of AIDS and of survival were an increased CD4 lymphocyte count (>50/μL), a decreased neopterin level (>2.4 nmol/L), and no increase in the number of symptoms after 7–12 months of zidovudine therapy. Men who had the best quartile CD4 lymphocyte and neopterin responses and who also had no increase in the number of symptoms were 23 times less likely to die (reflecting a 96% increase in survival) than were men who had the worst responses in these variable categories. After 7–12 months of zidovudine therapy, 5-year survival rates were 63% for men with good responses in all three variable categories, 47%–49% for those with good CD4 lymphocyte responses and good responses in one other variable category, 31% for those with only a good CD4 lymphocyte response, and 0 for those with poor responses in all three variable categories.

    Original languageEnglish (US)
    Pages (from-to)352-362
    Number of pages11
    JournalClinical Infectious Diseases
    Volume20
    Issue number2
    DOIs
    StatePublished - 1995

    Fingerprint

    Decision Support Techniques
    Zidovudine
    Neopterin
    HIV
    Lymphocytes
    Survival
    Virus Diseases
    CD4 Lymphocyte Count
    Acquired Immunodeficiency Syndrome
    Survival Rate
    Therapeutics

    ASJC Scopus subject areas

    • Infectious Diseases
    • Microbiology (medical)
    • Immunology

    Cite this

    Prognostic value of combined response markers among human immunodeficiency virus-infected persons : Possible aid in the decision to change zidovudine monotherapy. / Graham, Neil M H; Park, Lawrence P.; Piantadosi, Steven; Phair, John P.; Mellors, John; Fahey, John L.; Saah, Alfred J.

    In: Clinical Infectious Diseases, Vol. 20, No. 2, 1995, p. 352-362.

    Research output: Contribution to journalArticle

    Graham, Neil M H ; Park, Lawrence P. ; Piantadosi, Steven ; Phair, John P. ; Mellors, John ; Fahey, John L. ; Saah, Alfred J. / Prognostic value of combined response markers among human immunodeficiency virus-infected persons : Possible aid in the decision to change zidovudine monotherapy. In: Clinical Infectious Diseases. 1995 ; Vol. 20, No. 2. pp. 352-362.
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    abstract = "To clarify useful clinical parameters for determining the need for changes in antiretroviral regimens, 586 persons who were seropositive for the human immunodeficiency virus (HIV) and who had intermediate-stage HIV disease underwent follow-up semiannually for a median of 3.1 years after zidovudine monotherapy was instituted. The strongest predictors of time to the development of AIDS and of survival were an increased CD4 lymphocyte count (>50/μL), a decreased neopterin level (>2.4 nmol/L), and no increase in the number of symptoms after 7–12 months of zidovudine therapy. Men who had the best quartile CD4 lymphocyte and neopterin responses and who also had no increase in the number of symptoms were 23 times less likely to die (reflecting a 96{\%} increase in survival) than were men who had the worst responses in these variable categories. After 7–12 months of zidovudine therapy, 5-year survival rates were 63{\%} for men with good responses in all three variable categories, 47{\%}–49{\%} for those with good CD4 lymphocyte responses and good responses in one other variable category, 31{\%} for those with only a good CD4 lymphocyte response, and 0 for those with poor responses in all three variable categories.",
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