[The prognostic markers of HIV infection progression. A study of the p24 antigen in a cohort of 251 patients].
BACKGROUND
Prospective study of AIDS or death progression in a cohort of 251 HIV infected patients whose time of seroconversion is unknown, with 2 main objectives: 1. To analyse plasma level p24 antigen as a marker of progression. 2. To evaluate stability of plasma levels of p24 antigen as a marker of progression.


METHODS
251 patients were studied, most on antiretroviral therapy, who were attended at HIV/AIDS Unit of Internal Medicine Service of the Hospital Universitario Arnau de Vilanova de Lleida. Mean initial CD4 cell count were 376 x 10(6)/L (range: 0.8-1350) 51 cases had been diagnosed previously with AIDS, their were therefore excluded. Analysis of survival, according to initial plasma p24 antigen and Cd4 cell count as well as the stability of plasma level p24 antigen was performed by Kaplan-Meier test. Relative risk were calculate by Cox's proportional hazard model.


RESULTS
During a follow-up period of 24 months, 38 patients progressed to AIDS or died. Relative risk (RR) of progression to AIDS or death related to the group with p24 antigen < 40 pg/ml was 5.48 when p24 antigen => 40 pg/ml (p < 0.0005). Relative risk of progression to AIDS or death for the patients with unstable plasmatic level of p24 antigen related to the group with stable plasmatic level was 4.25 (p < 0.0005).


CONCLUSIONS
Plasma level and stability of p24 antigen are useful as a markers of risk of AIDS progression or death and they behaves as an independent prognostic markers in our patients. p24 antigen < 40 pg/ml is associated with a better prognosis.
Rubio Caballero
M
M
Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Lleida.
Nogués Biau
A
A
Falguera Sacrest
M
M
Puig Ganau
T
T
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D015331:Cohort Studies; D018450:Disease Progression; D016655:HIV Core Protein p24 / Q000097:blood*; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality; D015497:HIV-1; D006801:Humans; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D019562:Viral Load
D015415:Biomarkers; D016655:HIV Core Protein p24