title: Prognostic value of the CD4+ T cell count for HIV-1 infected patients with advanced immunosuppression.
abstract: The prognostic value of the CD4+ T cell count is not clearly established for HIV-1 infected patients with an advanced immunosuppression. The aim of this study was to assess the relationship between CD4+ T cell counts and survival in patients with less than 50 CD4+ T cells per mm3 (/mm3). We examined an historical cohort of 97 patients with 2 consecutive CD4+ T cells determinations < 50/mm3 within 3 months, followed at a university hospital of the University of Montreal. The proportion of men was 93% with 74% being homo/bisexual. The means of the 2 CD4+ T cell counts/mm3 were 25 and 25.1 respectively. Median survival after the first CD4+ T cell count < 50 CD4+ T cells/mm3 was 15.2 months. Using the proportional hazard model, the median survival of patients with 2 consecutive CD4+ T cell counts < or = 20/mm3 was 9.3 months compared to 19.2 for those with 20-50 CD4+ T cells/mm3 (P < 0.0001). It seems then, that the CD4+ T cell count is a helpful prognostic marker, even in very immunosuppressed patients. Its prognostic value is more accurate if the measurement is replaced within 1-3 months because of high variability at this level of immunosuppression.
authors.affiliation: Department of Social and Preventive Medicine, University of Montreal, Quebec, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Vanhems
authors.forename: R
authors.initials: R
authors.lastname: Allard
authors.forename: E
authors.initials: E
authors.lastname: Toma
authors.forename: L
authors.initials: L
authors.lastname: Cyr
authors.forename: R
authors.initials: R
authors.lastname: Beaulieu
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D007165:Immunosuppression Therapy; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis