title: A decrease in albumin in early HIV type 1 infection predicts subsequent disease progression.
abstract: We investigated the association between albumin levels and HIV-1 disease progression among 78 Kenyan women followed from before infection through a median of 70 months. With HIV-1 acquisition, median albumin decreased from 38.5 g/liter to 36.8 g/liter (p = 0.07) and the prevalence of hypoalbuminemia increased from 16% to 32% (p = 0.02). Each 1 g/liter decrease in albumin with HIV-1 acquisition was associated with a 13% increase (p = 0.01) in the risk of progressing to a CD4 count <200 cells/mul, after adjustment for set point plasma viral load. A decrease in albumin of over 10% was associated with a 3.5-fold increase in the risk of progressing to a CD4 count <200 cells/mul (95% CI 1.4-9.0, p = 0.008). Trends for an increased risk of mortality were also seen. A greater decrease in albumin levels accompanying HIV-1 acquisition may be a marker for changes in early infection associated with more rapid disease progression.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington 98104, USA. grahamsm@u.washington.edu
authors.forename: Susan M
authors.initials: SM
authors.lastname: Graham
authors.forename: Jared M
authors.initials: JM
authors.lastname: Baeten
authors.forename: Barbra A
authors.initials: BA
authors.lastname: Richardson
authors.forename: Mark H
authors.initials: MH
authors.lastname: Wener
authors.forename: Ludo
authors.initials: L
authors.lastname: Lavreys
authors.forename: Kishorchandra
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Jeckoniah O
authors.initials: JO
authors.lastname: Ndinya-Achola
authors.forename: Julie
authors.initials: J
authors.lastname: Overbaugh
authors.forename: R Scott
authors.initials: RS
authors.lastname: McClelland
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000503:physiopathology* / Q000821:virology; D015497:HIV-1; D006801:Humans; D007630:Kenya; D015995:Prevalence; D012709:Serum Albumin / Q000032:analysis*; D011477:Sex Work; D019562:Viral Load
chemical_list: D012709:Serum Albumin