The Prognostic Value of Cellular and Serologic Markers in Infection with Human Immunodeficiency Virus Type 1
| العنوان: | The Prognostic Value of Cellular and Serologic Markers in Infection with Human Immunodeficiency Virus Type 1 |
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| المؤلفون: | Jeremy M. G. Taylor, John L. Fahey, Pari Nishanian, Roger Detels, Raphael Melmed, Bo Hofmann, Janis V. Giorgi |
| المصدر: | New England Journal of Medicine. 322:166-172 |
| بيانات النشر: | Massachusetts Medical Society, 1990. |
| سنة النشر: | 1990 |
| مصطلحات موضوعية: | CD4-Positive T-Lymphocytes, Male, Interleukin 2, HIV Core Protein p24, Gene Products, gag, Immunoglobulin E, Neopterin, T-Lymphocytes, Regulatory, Cohort Studies, Leukocyte Count, chemistry.chemical_compound, Immunopathology, HIV Seropositivity, Humans, Medicine, Prospective Studies, Acquired Immunodeficiency Syndrome, biology, business.industry, Viral Core Proteins, Receptors, Interleukin-2, General Medicine, T lymphocyte, Prognosis, Biopterin, Immunoglobulin A, chemistry, Multivariate Analysis, HIV p24 Antigen, Immunology, HIV-1, biology.protein, Antibody, beta 2-Microglobulin, business, Biomarkers, CD8, medicine.drug |
| الوصف: | We evaluated three cellular and five serologic markers that are affected by infection with the human immunodeficiency virus type 1 (HIV-1) for their ability to predict the progression to clinical acquired immunodeficiency syndrome (AIDS). The cellular markers were the number of CD4+ T cells, the number of CD8+ T cells, and the ratio of CD4+ T cells to CD8+ T cells. The serologic markers were the serum levels of neopterin (a product of stimulated macrophages), beta 2-microglobulin, soluble interleukin-2 receptors, IgA, and HIV p24 antigen. We evaluated the usefulness of these measures as markers of the progression to AIDS prospectively, over four years, in a cohort of 395 HIV-seropositive homosexual men who were initially free of AIDS. CD4+ T cells (expressed as an absolute number, a percentage of lymphocytes, or a ratio of CD4+ to CD8+ T cells) were the best single predictor of the progression to AIDS, but the serum neopterin and beta 2-microglobulin levels each had nearly as much predictive power. The neopterin level appeared to be a slightly better predictor than the beta 2-microglobulin level. The levels of IgA, interleukin-2 receptors, and p24 antigen had less predictive value. A stepwise multivariate analysis indicated that the best predictors, in descending order, were CD4+ T cells (the percentage of lymphocytes or the CD4+: CD8+ ratio), the serum level of neopterin or beta 2-microglobulin, the level of IgA, that of interleukin-2 receptors, and that of p24 antigen. The last three markers had little additional predictive power beyond that of the first two. We conclude that of the eight markers studied, progression to AIDS was predicted most accurately by the level of CD4+ T cells in combination with the serum level of either neopterin or beta 2-microglobulin. At least one of these two serum markers, which reflect immune activation, should be used along with measurement of CD4+ T cells in disease-classification schemes and in the evaluation of responses to therapy. |
| تدمد: | 1533-4406 0028-4793 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dcb6848b9925a9dfd0187d13ac3234df https://doi.org/10.1056/nejm199001183220305 |
| رقم الأكسشن: | edsair.doi.dedup.....dcb6848b9925a9dfd0187d13ac3234df |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15334406 00284793 |
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