title: Analysis of clinical AIDS-free interval after CD4+ cell counts fall below 200 x 10(6) L-1 in Japanese haemophiliacs infected with HIV-1.
abstract: We analysed the time from the date CD4+ cell counts fell below 200 x 10(6) L-1, defined as ti, to the onset of clinical AIDS, according to the 1987 Centers for Disease Control and Prevention case definition, in 129 Japanese haemophilia patients infected with HIV-1. The cumulative onset of clinical AIDS was analysed by the Kaplan-Meier method and proportional hazard model. Incorporated covariates were age of each patient at time ti, as well as CD4+ and CD8+ cell counts, serum levels of IgG, IgA, IgM, GOT and GPT at ti. The time of antiretroviral treatment initiation was also considered. The 50% AIDS-free interval after ti was 3.00 years (95% confidence interval (CI), range 0.49-5.51) and 1.71 years (95% CI, range 0.66-2.76) for the patients at CDC stage II and stage III, respectively (significantly different, P = 0.0013). Among the patients at CDC stage II at ti, higher levels of IgA were tightly associated with a shorter period from ti to onset of clinical AIDS (P < 0.0001), and relative hazard was 1.35 (95% CI, 1.11-1.64) with increase of IgA level by 1.0 g L-1. Thus there is a broad distribution in the time to onset of clinical AIDS in Japanese haemophiliacs even after CD4+ cell counts fall below 200 x 10(6) L-1. This should be taken into consideration in deciding upon the therapy and care of HIV-1 infected people.
authors.affiliation: Radioisotope Research Institute, St Marianna University School of Medicine, Kawaski, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Tatsunami
authors.forename: J
authors.initials: J
authors.lastname: Mimaya
authors.forename: T
authors.initials: T
authors.lastname: Meguro
authors.forename: R
authors.initials: R
authors.lastname: Kuwabara
authors.forename: N
authors.initials: N
authors.lastname: Yago
authors.forename: K
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D018791:CD4 Lymphocyte Count; D006467:Hemophilia A / Q000276:immunology*; D006801:Humans; D007564:Japan; D011379:Prognosis; D016016:Proportional Hazards Models; D012074:Remission Induction
chemical_list: D015415:Biomarkers