Important note: Information in this article was accurate in October 2005. The state of the art may have changed since the publication date.
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AIDSWEEKLY Plus; Monday, October 10, 2005
Staff Medical Writers
According to a study from the United States, "Prognostic markers for HIV monitoring are needed for resource-limited regions. Prior research has demonstrated rapid declines in total lymphocyte count (TLC) and hemoglobin levels before AIDS, but the prognostic accuracy of these declines has not been examined prospectively.
"Longitudinal TLC and hemoglobin data from men in the Multicenter AIDS Cohort Study (MACS) before the introduction of potent HIV therapy were used to identify the first time when the TLC was greater than or equal to1200 cells/mm3, TLC declined by >33% per year, and hemoglobin declined by >11.6% per year."
"The prognostic value of these declines for AIDS was evaluated by Cox regression models and Kaplan-Meier survival curves. Rapid declines in TLC or hemoglobin were associated with progression to AIDS (relative hazard [RH]=4.70, 95% confidence interval [CI]: 3.23-6.86 for TLC; RH=5.55, 95% CI: 3.69-8.36 for hemoglobin)," reported scientists.
"The World Health Organization criterion for initiating therapy, a TLC less than or equal to1200 cells/mm3, was also predictive of progression to AIDS (RH=6.14, 95% CI: 4.33-8.71).
"Even among those with a TLC >1200 cells/mm3, a rapid decline in TLC or hemoglobin was strongly associated with progression to AIDS (RH=2.53, 95% CI: 1.56-4.10 for TLC; RH=5.28, 95% CI: 3.11-8.97 for hemoglobin)," wrote B. Lau and colleagues at Johns Hopkins University.
"In the MACS," the authors continued, "rapid declines in TLC or hemoglobin concentration indicated an increased likelihood of progression of HIV infection to AIDS."
"These results support the potential utility of these markers for monitoring HIV-infected people in resource-limited regions," Lau concluded, "but critical levels and rates of decline of markers for such regions remain to be defined."
Lau and colleagues published the results of their research in Journal of Acquired Immune Deficiency Syndromes (Use of total lymphocyte count and hemoglobin concentration for monitoring progression of HIV infection. J Acquir Immune Defic Syndr. 2005 Aug 15;39(5):620-5.
For additional information, contact S.J. Gange, Johns Hopkins University, Bloomberg School Publ Health, Dept. Epidemiology, 615 N Wolfe St., Room E-7638, Baltimore, MD 21205, USA.
The publisher of the Journal of Acquired Immune Deficiency Syndromes can be contacted at: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.
Keywords: Baltimore, Maryland, United States, HIV/AIDS, Prognostic Indicator, Hemoglobin Concentration, Lymphocyte Count, Disease Progression.
This article was prepared by AIDS Weekly editors from staff and other reports.
Reference
Lau B, Gange SJ, Phair JP, et al. Use of total lymphocyte count and hemoglobin concentration for monitoring progression of HIV infection, J Acquir Immune Defic Syndr. 2005 Aug 15;39(5):620-5.
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