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Risk sets for time to AIDS and survival based on pre and post-treatment prognostic markers.
Piantadosi S; Graham N; Park L; Saah A; Kaslow R; Detels R; Rinaldo C;
December 30, 1995
Natl Conf Hum Retroviruses Relat Infect (1st). 1993 Dec 12-16;:131.

A sustained rise in CD4+ lymphocyte count in zidovudine- treated patients is associated with increased AIDS-free and survival time. Additionally, changes in other immunologic and hematologic markers carry clinically and statistically significant prognostic information for AIDS-free and survival time. We studied 747 AIDS-free patients from initiation of zidovudine therapy in the MACS to determine quantitatively the absolute and relative risks associated with their prognostic markers. Patients were seen semi- annually and had data collected on medication use, immunologic and hematologic variable and clinical outcomes. AIDS was diagnosed in 216 patients and 165 died over the median follow-up period of 2.5 years. Subsets of patients with clinically and statistically significant differences in prognosis were identified using multiple regression survival models and pre-treatment measurements of CD4+ lymphocytes, platelet count, hemoglobin, and changes in these parameters during the first 6-12 months on zidovudine therapy. Using these methods, we demonstrate how individual patients can be classified into one of several risk groups which yields clinically useful prognostic information. Patients in the most favorable risk category have over a 90% probability of remaining AIDS free at 2 years whereas those in the highest risk category have only a 25% chance of remaining AIDS free at 2 years. We also present user friendly computer software based on these methods that can assist the physician in identifying a quantitative risk profile for the individual patient.

Didanosine/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Drug Administration Schedule Human HIV Infections/*DRUG THERAPY Polymerase Chain Reaction RNA, Viral Viremia Zidovudine/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE ABSTRACT