title: Lung CD4 lymphocytes predict survival in asymptomatic HIV infection.
abstract: BACKGROUND
  Plasma viral load and blood CD4 counts are accepted indicators of severity of illness in patients with HIV-1. Lung CD4 counts have not been evaluated in asymptomatic HIV-1 patients as indicators of disease severity.
  
  
  OBJECTIVE
  To determine if lung lymphocyte counts in asymptomatic subjects with HIV compare with plasma viral loads and blood CD4 counts in predicting survival.
  
  
  METHODS
  Retrospective, cross-sectional analysis.
  
  
  METHODS
  Midwestern urban community, December 1996 to August 1998.
  
  
  METHODS
  HIV-seropositive subjects (n = 95) without AIDS-related pulmonary complications.
  
  
  METHODS
  Plasma viral load, blood hemoglobin and blood lymphocyte subtypes, lung lymphocyte subtypes from BAL, body mass index, and mortality.
  
  
  RESULTS
  Eight of the 95 subjects (8.4%) had died at the 4-year follow-up. Lung CD4 counts were significantly related to mortality by univariable analysis (2.5 x 10(3)/mL vs 0.9 x 10(3)/mL, median values for survivors vs nonsurvivors, respectively, p = 0.010). Modeling using exact methods further showed lung CD4 counts to be a significant predictor of survival after individually adjusting for potential confounders, including plasma viral load and blood CD4 count.
  
  
  CONCLUSIONS
  Lung CD4 counts in patients with HIV-1 infection may provide an independent predictor of survival.
authors.affiliation: Pulmonary and Critical Care Division, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University, Columbus, OH 43210, USA. wewers.2@osu.edu
authors.forename: Mark D
authors.initials: MD
authors.lastname: Wewers
authors.forename: Stanley
authors.initials: S
authors.lastname: Lemeshow
authors.forename: Amy
authors.initials: A
authors.lastname: Lehman
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Clanton
authors.forename: Philip T
authors.initials: PT
authors.lastname: Diaz
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000276:immunology; D001999:Bronchoscopy; D018791:CD4 Lymphocyte Count; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000097:blood / Q000276:immunology* / Q000401:mortality; D006801:Humans; D007958:Leukocyte Count; D008168:Lung / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012907:Smoking; D016019:Survival Analysis