Clinical correlation of the immunological markers of HIV infection in individuals from Thailand.
OBJECTIVE
To evaluate the usefulness of T-cell subsets, beta-microglobulin (B2M), p24 antigen and anti-p24 antibodies as differentiating and prognostic markers in HIV-infected Thai patients.


METHODS
Sixty-one HIV-infected patients in various stages of disease (six AIDS, three AIDS-related complex, 34 persistent generalized lymphadenopathy and 18 HIV-asymptomatic) were followed prospectively for 2 years. Patients were examined and immunological markers assessed every 6 months at least. Any HIV-related complications were treated symptomatically and clinical staging was re-evaluated at each visit. Due to financial constraints, none of the patients were given antiretroviral drugs.


METHODS
T-cell subsets were enumerated by indirect immunofluorescence using OKT4 or OKT8 for T-helper and T-suppressor cells, respectively. beta 2M and p24 antigen were quantified by enzyme-linked immunosorbent assay and anti-p24 antibodies were by immunoblot assay.


RESULTS
Our preliminary study revealed that the decrease in CD4+ T-cells or anti-p24 titre and the increase in p24 antigen or beta 2M correlated well with disease staging, as defined by the Centers for Disease Control. Absolute number and percentage of CD4+ T-cells, absolute number of CD8+ T-cells, beta 2M level and p24 antigen and anti-p24 antibody levels at entry could be used as reliable prognostic markers for HIV progression. The combination of p24 antigen with the number of CD4+ T-cells substantially increased the prognostic value, compared with either used alone.


CONCLUSIONS
The annual rate of clinical progression from asymptomatic to symptomatic HIV infection in our study was 6.8%. The results we obtained in this preliminary study may be used as baseline data for planning future therapeutic interventions in Asian patients.
Sirivichayakul
S
S
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Phanuphak
P
P
Hanvanich
M
M
Ruxrungtham
K
K
Panmoung
W
W
Thanyanon
W
W
D000293:Adolescent; D000328:Adult; D000943:Antigens, Differentiation / Q000032:analysis*; D005260:Female; D005500:Follow-Up Studies; D016655:HIV Core Protein p24 / Q000032:analysis*; D015658:HIV Infections / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016176:T-Lymphocyte Subsets / Q000737:chemistry*; D013785:Thailand / Q000453:epidemiology; D001613:beta 2-Microglobulin / Q000032:analysis* / Q000276:immunology
D000943:Antigens, Differentiation; D016655:HIV Core Protein p24; D001613:beta 2-Microglobulin