Immunological predictors of survival in HIV type 2-infected rural villagers in Guinea-Bissau.
We investigated the association between beta2-microglobulin, neopterin, serum levels of soluble urokinase-type plasminogen activator receptor (suPAR), CD4 count, and plasma viremia with survival in 133 HIV-2-infected villagers and 160 controls living in rural Guinea-Bissau. Subjects were recruited in 1991 and visited at home every 3-6 months until 1998. Median beta2-microglobulin, neopterin, and suPAR were significantly higher and CD4% significantly lower among HIV-2-infected individuals than controls. Thirty-one HIV-2-infected individuals died and 7 were lost to follow-up. beta2-Microglobulin, CD4%, and plasma viral load were associated independently with survival in multivariate analyses. Neopterin and suPAR did not reach statistical significance. These findings suggest that immune activation is central to the pathogenesis of HIV. They also have important implications for resource-poor settings where CD4 count and plasma viral load are unaffordable.
Medical Research Council Tropical Epidemiology Group, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. shabbar.jaffar@lshtm.ac.uk
Shabbar
S
Jaffar
Maarten Schim
MS
Van der Loeff
Jesper
J
Eugen-Olsen
Tim
T
Vincent
Ramu
R
Sarje-Njie
Pa
P
Ngom
Anne-Marie
AM
Meyer
Neil
N
Berry
Peter
P
Aaby
Hilton
H
Whittle
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D018791:CD4 Lymphocyte Count; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality* / Q000821:virology; D015498:HIV-2 / Q000472:pathogenicity / Q000502:physiology*; D006801:Humans; D008297:Male; D037241:Mannose-Binding Lectins / Q000097:blood; D008562:Membrane Glycoproteins / Q000097:blood; D008875:Middle Aged; D019798:Neopterin / Q000097:blood; D011237:Predictive Value of Tests; D011956:Receptors, Cell Surface / Q000097:blood; D012424:Rural Population; D016019:Survival Analysis; D019562:Viral Load; D001613:beta 2-Microglobulin / Q000097:blood
D015415:Biomarkers; C404106:MRC2 protein, human; D037241:Mannose-Binding Lectins; D008562:Membrane Glycoproteins; D011956:Receptors, Cell Surface; D001613:beta 2-Microglobulin; D019798:Neopterin