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The relationship between beta-2-microglobulin, CD4 lymphocyte count, AIDS and death in HIV-positive individuals

Published online by Cambridge University Press:  01 June 1997

A. MOCROFT
Affiliation:
HIV Research Unit, Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3 2PF, UK
M. A. JOHNSON
Affiliation:
Department of Thoracic Medicine, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3 2PF, UK
C. A. SABIN
Affiliation:
HIV Research Unit, Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3 2PF, UK
M. BOFILL
Affiliation:
Department of Immunology, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3 2PF, UK
G. JANOSSY
Affiliation:
Department of Immunology, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3 2PF, UK
A. N. PHILLIPS
Affiliation:
HIV Research Unit, Department of Primary Care and Population Sciences, Royal Free Hospital School of Medicine, Rowland Hill Street, London NW3 2PF, UK
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Abstract

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The relationship, in 539 individuals infected with the human immunodeficiency virus (HIV), between two prognostic markers, the CD4 count and beta-2-microglobulin (B2M), and the development of the acquired immunodeficiency syndrome (AIDS) and death was investigated. Cox proportional hazards models were used to determine the risk of AIDS or death. In a multivariate model which adjusted for demographic factors and treatment, the most recent measurements of B2M (relative hazard (RH) 1·37 per g/l higher) and CD4 count (RH 2·17 per log-unit lower) were both significantly associated with the development of AIDS. Similarly, in a multivariate model which additionally adjusted for the development of AIDS as a time dependant covariate, there was a strong relationship with risk of death for the most recent measurements of B2M (RH 1·34 per g/l higher), and CD4 lymphocyte count (RH 1·91 per log-unit lower). A difference in the level of B2M could be used among patients with similar CD4 counts as an indicator of increased risk of progression to AIDS or death. Using the most recent values of these markers provides a better estimate of the risk of AIDS or death, compared to the more common method of analysis, where baseline values of the markers are used.

Type
Research Article
Copyright
© 1997 Cambridge University Press