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Outcome of HIV-infected patients after their CD4 is lower than 50/mm3.


Int Conf AIDS. 1994 Aug 7-12;10(2):142 (abstract no. PB0582). Unique

OBJECTIVE: To assess the characteristics, clinical course and outcome for HIV-infected patients who developed a severe depletion of CD4 lymphocytes (CD4 < 50/mm3). METHODS: We evaluated retrospectively 96 patients in whom 2 consecutive CD4 counts (within 3 months) were firstly < 50/mm3 (time 0 = T0). The medical charts review covered demography, risk factors, HIV-related events before and after T0, treatments, CD4 and CD8 counts. Survival was analysed by the Kaplan-Meier methods and the logrank test was used for comparisons. We report the preliminary results of 63 patients whose T0 was determined between 01/03/89 and 01/03/93. RESULTS: The proportion of males was 94% and 71% of patients were homo/bisexual. The mean age was 37.5 years. The mean of the CD4 count was 23/mm3 at T0. For 43 patients (68%) AIDS was diagnosed before T0, 14 after T0, 4 at the same time. At time of analysis, 46 (73%) were not alive. The incidence cases of common AIDS-related events before and after T0 was 38% and 36.5% for PCP, 30% and 12.5% for Kaposi sarcoma, 12.5% and 33.5% for candida esophagitis, 3% and 22% for CMV infections and 1.5% and 16% for mycobacterial infections (MAI) respectively (X2 test, 4 df, p < 0.0001). The median of survival after T0 was 14.2 months (M). Survival was shorter for patients with CD4 count < 25/mm3 (median 11.3 M) than > 25/mm3 (median 18.5 M, p = 0.04). There was no difference of survival between patients diagnosed with AIDS before T0 (median 12 M) and after T0 (median 15.5 M, p = 0.59). Anti-HIV therapy was prescribed in 51 patients (81%). Nine patients (14%) were alived more than 24 M after T0 (median 33.6 M) with AIDS median survival of 38 M. CONCLUSIONS: MAI and CMV infection increase by 10.5 and 7 fold respectively after CD4 < 50/mm3. The survival time after the occurence of CD4 < 50/mm3 is longer than 12 M. The survival is better for patients with a first count of CD4 > 25/mm3, at T0.

Acquired Immunodeficiency Syndrome/IMMUNOLOGY/*MORTALITY/THERAPY Adult CD4-CD8 Ratio *CD4-Positive T-Lymphocytes Female Human *Leukocyte Count Male Retrospective Studies Survival Rate ABSTRACT


Information in this article was accurate in December 30, 1994. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.