Lung CD4 lymphocytes predict survival in asymptomatic HIV infection.
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.
Wewers
Mark D
MD
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
Lemeshow
Stanley
S
Lehman
Amy
A
Clanton
Thomas L
TL
Diaz
Philip T
PT
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