Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
PREDICTORS OF HIV DISEASE PROGRESSION
AIDS Clinical Review 1990. Volberding P and Jacobson MA, eds. New York, Marcel Dekker, p. 63-79, 1990.. Unique Identifier : AIDSLINE ICDB/91675539 Hessol NA; Lifson AR; Res. Branch, AIDS Office, San Francisco Dept. of Public Health,; San Francisco, CA
Abstract:
Whether all those infected with HIV will develop disease is unknown. However, studies have suggested that certain clinical manifestations and laboratory measurements can help to determine who is most likely to develop HIV disease. The natural history of HIV infection is summarized briefly, and current information on predictors of HIV disease progression is reviewed. Topics include defining predictors of HIV disease progression, HIV infection and disease progression (homosexual and bisexual men, iv drug users, recipients of blood and blood products, and perinatally infected children), clinical and laboratory predictors of HIV disease progression, and cofactors for HIV disease progression. Clinical predictors of HIV disease progression that have continued to be associated with adverse outcome are constitutional symptoms, thrush, and hairy leukoplakia. Laboratory predictors of HIV disease progression that have proven consistently to be important are T-cell subsets, p24 antigen, and beta-2 microglobulin. Although clinical predictors of HIV disease progression have been noted, several studies where both clinical and laboratory predictors have been subjected to multivariate analysis have shown that laboratory predictors have much greater prognostic significance. The relative importance of both clinical and laboratory predictors in relationship to each other, especially those that may be different measurements of the same biologic or immunologic response, is crucial to determining the true predictive value. There is now a considerable amount of information on predictors of disease progression, but it still may be difficult to determine an individual's risk of disease development without repeated laboratory and clinical measures over time. Information derived from studies of groups must be used cautiously when it is applied to a single individual. At this time, specific clinical signs or laboratory tests that have been reported to have predictive value should not be considered in isolation but in the context of all available clinical and laboratory information. (73 Refs)
Keywords: beta 2-Microglobulin/ANALYSIS Acquired Immunodeficiency Syndrome/DIAGNOSIS AIDS Serodiagnosis/*METHODS AIDS-Related Complex/DIAGNOSIS Gene Products, gag/ANALYSIS Human HIV Infections/*DIAGNOSIS/IMMUNOLOGY/TRANSMISSION Leukocyte Count Risk Factors T-Lymphocyte Subsets/IMMUNOLOGY Viral Core Proteins/ANALYSIS MONOGRAPH REVIEW 911030
M91A1127
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
