title: Prognostic factors in human immunodeficiency virus-positive patients with a CD4+ lymphocyte count < 50/microL.
abstract: This analysis investigated variability of survival time in a cohort of 553 human immunodeficiency virus type 1 (HIV-1)-infected homosexual or bisexual men with < 50 CD4+ cells/microL. Median survival after the first CD4+ cell count < 50/microL was 1.34 years; 25% survived > or = 2 years. Multivariate analysis showed longer survival with concurrent acyclovir and zidovudine use, hemoglobin > or = 12 g/dL, and full-time employment (P < .0001). Other significant covariates associated with longer survival included African-American race, no prior AIDS illness, weight loss < 4.5 kg, and zidovudine use (with or without concurrent acyclovir) after CD4+ cells fell to < 50/microL. An easily derived score identified Multicenter AIDS Cohort Study subjects likely to survive > 2 years after CD4+ cell count was < 50/microL. Survival once CD4+ cell count fell below 50/microL may be longer for persons with a good performance status and specific clinical markers. Health care providers should consider these variables in decision-making strategies and design of clinical trials.
authors.affiliation: Northwestern University Medical School, Chicago, Illinois 60611.
authors.forename: E G
authors.initials: EG
authors.lastname: Apolonio
authors.forename: D R
authors.initials: DR
authors.lastname: Hoover
authors.forename: Y
authors.initials: Y
authors.lastname: He
authors.forename: A J
authors.initials: AJ
authors.lastname: Saah
authors.forename: D W
authors.initials: DW
authors.lastname: Lyter
authors.forename: R
authors.initials: R
authors.lastname: Detels
authors.forename: R A
authors.initials: RA
authors.lastname: Kaslow
authors.forename: J P
authors.initials: JP
authors.lastname: Phair
mesh_terms: D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D001727:Bisexuality; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000401:mortality*; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D015996:Survival Rate; D015215:Zidovudine / Q000627:therapeutic use
chemical_list: D015215:Zidovudine; D000212:Acyclovir