Serum beta 2-microglobulin at HIV-1 seroconversion as a predictor of severe immunodeficiency during 10 years of followup.
In order to examine the relevance of early immune activation to the long-term course of HIV infection, we evaluated the ability of the serum beta 2-microglobulin level measured in 63 haemophiliacs on average 4.9 months from HIV seroconversion to predict the rate of development of server immunodeficiency (CD4) lymphocyte count 50/mm3) or AIDS over the following 10 years. Patients with higher beta 2-microglobulin values tended to develop severe immunodeficiency/AIDS more rapidly than those with lower levels (relative risk 1.68 per 1 mg/L increase; 95% CI 1.26-2.26; p = 0.0004). Older patients also progressed more rapidly, and these two factors acted independently (relative risk 1.65 per 1 mg/L increase; 95% CI 1.21-2.72; p = 0.002 for beta 2-microglobulin and 1.22 per 10 years; 95% CI 1.01-1.48; p = 0.04 for age). These results provide further evidence that the long-term course of HIV infection can, to some extent, be predicted soon after infection. Older patients with high beta 2-microglobulin levels warrant close monitoring and consideration for early antiretroviral therapy.
Department of Haematology, Royal Free Hospital School of Medicine, London, UK.
A N
AN
Phillips
C A
CA
Sabin
J
J
Elford
M
M
Bofill
A
A
Timms
G
G
Janossy
C A
CA
Lee
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000276:immunology* / Q000378:metabolism*; D006679:HIV Seropositivity / Q000378:metabolism*; D015497:HIV-1; D006467:Hemophilia A / Q000150:complications* / Q000276:immunology / Q000378:metabolism / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D001613:beta 2-Microglobulin / Q000032:analysis*
D015415:Biomarkers; D001613:beta 2-Microglobulin