Early predictors of survival in symptomatic HIV-infected persons treated with high-dose zidovudine.
The survival times of 246 patients treated with high-dose zidovudine beginning in 1986 were obtained through November 1988. We analyzed clinical and laboratory predictors of survival as measured before initiation of therapy and during the first 32 weeks of therapy. In a multivariate proportional-hazards model, we found significant independent predictive abilities for four pretherapy measurements (AIDS versus ARC diagnosis, Karnofsky performance score, age, and hemoglobin) and four measurements made during therapy (change in log CD4 lymphocyte count from pretherapy to week 24, CD8 lymphocyte count at week 24, rate of decline of hemoglobin over the first 3 months of therapy, and rate of decline in white blood count over the first 6 months of therapy). The presence of three predictors measured during therapy that are statistically significant when controlled for changes in CD4 count suggests that the use of other measures in addition to CD4 counts may substantially improve the prediction of long-term survival based on early response of surrogate markers to therapy.
Bacchetti
P
P
Department of Epidemiology and Biostatistics, University of California, San Francisco.
Moss
A R
AR
Andrews
J C
JC
Jacobson
M A
MA
D004334:Drug Administration Schedule; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D012044:Regression Analysis; D016019:Survival Analysis; D006377:T-Lymphocytes, Helper-Inducer / Q000187:drug effects; D050378:T-Lymphocytes, Regulatory / Q000187:drug effects; D015215:Zidovudine / Q000627:therapeutic use*
D015215:Zidovudine