Immune activation markers and AIDS prognosis.
Four assays for serum levels of cellular products of immune activation were examined as prognostic markers for AIDS in a prospective study of asymptomatic HIV-seropositive homosexual men. Baseline serum values of beta 2-microglobulin (beta 2M), neopterin, soluble CD8 (sCD8), and soluble interleukin-2 receptor (sIL-2R) for 185 men were examined univariately and multivariately as predictors of AIDS during 36 months of follow-up. Thirty-three cases of AIDS (18%) were diagnosed during the follow-up period. All four assays correlated highly with each other (r = 0.48-0.63), and all four were good univariate predictors of AIDS and comparable to CD4 lymphocyte count. beta 2M, neopterin, and sCD8 predicted AIDS independently of both CD4 count and HIV p24 antigen or p24 antibody in multivariate analysis. Within the range of CD4 count 200-499 x 10(6) cells/l, an immune activation marker used in combination with an assay for p24 antigen identifies those at 3-6% risk of AIDS over 36 months (low risk on both assays) and those at 63-86% risk (high risk on both assays). These results can be used to guide physicians and patients making decisions about treating asymptomatic HIV infection with zidovudine in individuals with CD4 lymphocyte count of 200-499 x 10(6) cells/l.
Department of Epidemiology and Biostatistics, University of California, San Francisco.
D H
DH
Osmond
S
S
Shiboski
P
P
Bacchetti
E E
EE
Winger
A R
AR
Moss
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology*; D000945:Antigens, Differentiation, T-Lymphocyte / Q000097:blood*; D001708:Biopterins / Q000031:analogs & derivatives* / Q000097:blood; D015704:CD4 Antigens / Q000097:blood; D015496:CD4-Positive T-Lymphocytes; D016827:CD8 Antigens; D015683:Gene Products, gag / Q000097:blood; D015483:HIV Antibodies / Q000097:blood; D015488:HIV Antigens / Q000097:blood; D016655:HIV Core Protein p24; D015658:HIV Infections / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D015999:Multivariate Analysis; D019798:Neopterin; D011379:Prognosis; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000097:blood*; D014758:Viral Core Proteins / Q000097:blood; D001613:beta 2-Microglobulin / Q000032:analysis*
D000945:Antigens, Differentiation, T-Lymphocyte; D015704:CD4 Antigens; D016827:CD8 Antigens; D015683:Gene Products, gag; D015483:HIV Antibodies; D015488:HIV Antigens; D016655:HIV Core Protein p24; D015375:Receptors, Interleukin-2; D014758:Viral Core Proteins; D001613:beta 2-Microglobulin; D001708:Biopterins; D019798:Neopterin