Survival after a very low (< 5 x 10(6)/l) CD4+ T-cell count in individuals infected with HIV.
OBJECTIVE
To describe survival after a CD4+ T-cell count of less than 5 x 10(6)/l and to identify possible baseline factors associated with outcome.


METHODS
A prospective cohort study.


METHODS
A large teaching hospital in North London.


METHODS
Patients treated at the Royal Free Hospital, London, who had at least one reported CD4+ T-cell count of less than 5 x 10(6)/l and were being followed up for clinical care prior to the date of this cell count.


METHODS
Death.


METHODS
Proportional hazards models, Kaplan-Meier analysis.


RESULTS
One-hundred and sixty-nine patients were included in the study. The median survival after a very low CD4+ T-cell count was 0.95 years (95% confidence interval, 0.78-1.19), although 20% survived for over 2 years. Older age and a previous AIDS diagnosis were related to poorer outcome. A higher CD8+ T-cell count at baseline was also associated with a better prognosis.


CONCLUSIONS
A CD4+ T-cell count of less than 5 x 10(6)/l did not necessarily mean imminent death, with a median survival after this count of just under 1 year. These results will enable clinicians to provide appropriate counselling for patients at this late stage and to plan terminal care.
Sabin
C A
CA
Department of Primary Care and Population Sciences, Royal Free Hospital and School of Medicine, London, UK.
Mocroft
A
A
Bofill
M
M
Janossy
G
G
Johnson
M
M
Lee
C A
CA
Phillips
A N
AN
D000293:Adolescent; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D018414:CD8-Positive T-Lymphocytes; D002648:Child; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality*; D006801:Humans; D008131:London / Q000453:epidemiology; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors