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HIV-1 plasma viral load and CD4 counts in surviving and non-surviving HIV-infected tuberculosis patients, Abidjan, Cote d'Ivoire.




 

Int Conf AIDS. 1998;12:152 (abstract no. 13329). Unique Identifier :

OBJECTIVE: To determine whether HIV-1 viral load and CD4 count measured at onset of tuberculosis (TB) therapy are associated with survival among HIV infected TB patients in Abidjan, Cote d'Ivoire. METHODS: As part of an ongoing cotrimoxazole prophylaxis trial in HIV-infected patients with pulmonary TB, plasma specimens obtained at the onset of TB therapy were selected from 64 patients known to have died and 78 surviving patients who were followed-up at least as long as the non-survivors. Lymphocyte subtyping was performed by standard flow cytometry and HIV-1 RNA plasma viral load was quantified by the modified HIV-1 Amplicor Monitor assay (Roche Diagnostics). Differences in mean CD4 count and mean log10 HIV-1 RNA viral load were compared by Student's t-test and the strength of association was assessed by the odds ratio (OR) and 95% confidence intervals (CI). RESULTS: The mean age of patients (35 years) and the proportion of males (61% vs 63%) was similar among survivors and non-survivors. The mean follow-up interval for non-survivors was 7 months (range 1-20) and for survivors was 8 months (1-21). In the combined groups, lower CD4 count and higher HIV viral load were correlated (correlation coefficient = -0.34, p < 0.001). Mean CD4 count and mean log10 HIV-1 viral load at enrollment were 161 cells/microliter (range 3-903) and 4.80 log10 copies/ml (2.60-6.50) for non-survivors and 391 cells/microliter (51-979) and 4.51 log10 copies/ml (2.35-6.10) for survivors (p < 0.05). When stratified by CD4 count, the mean log10 HIV-1 viral load in survivors vs non-survivors were no longer significantly different: 4.93 vs 4.89 for CD4 < 200 (p = 0.8); 4.55 vs 4.66 for CD4 200-500 (p = 0.7); and 4.11 vs 4.06 for CD4 > 500 (p = 0.9). In a multivariate analysis, non-survivors were significantly more likely than survivors to have a CD4 count < 200 (OR 7.5, CI 3.4-16.7) but not more likely to have a plasma HIV viral load > 4.0 log10 (10,000) copies/ml (OR 1.3, CI 0.5-3.6). CONCLUSION: In this population of HIV-infected TB patients, non-survivors had a higher viral load and lower CD4 count than survivors; however of the two parameters, only advanced immunosuppression (CD4 count < 200 cells/microliter) was significantly associated with death.

MEETING ABSTRACTS Adult Cote d'Ivoire CD4 Lymphocyte Count Female Human HIV Infections/*COMPLICATIONS/MORTALITY/VIROLOGY *HIV-1 Male RNA, Viral/ANALYSIS Survival Rate Tuberculosis/*COMPLICATIONS/VIROLOGY *Viral Load



 




Information in this article was accurate in December 30, 1998. 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.