CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update The Prognostic Value of Cellular and Serologic Markers in Infection with"
Fahey, John L., et al.
January 18, 1990
New England Journal of Medicine (01/18/90) Vol. 322, No. 3, P. 166
Progression to AIDS in HIV-infected patients is predicted most accurately
by the level of CD4+ T lymphocytes in combination with the serum level of
neopterin or beta-2-microglobulin, according to a study by John L. Fahey
and colleagues of the UCLA Schools of Medicine and Public Health. In a
four-year prospective study, the researchers monitored eight cellular and
serologic markers of immune activation to evaluate the usefulness of
these measures as indicators of the progression to AIDS in 395
HIV-positive men. The researchers report that the CD4+ T cell count
expressed as an absolute number or as a ratio of CD4+ to CD8+ was the
best single predictor; serum neopterin and beta-2-microglobulin levels
had nearly as much predictive power. Fahey and colleagues recommend that
at least one of these two serum markers, which reflect immune activation,
be used with CD4+ count in disease classification and in the evaluation
of response to therapy.