Mayer Kenneth H, Hogan Joseph W, Smith Dawn, Klein Robert S, Schuman Paula, Margolick Joseph B, Korkontzelou Christina, Farzedegan Homayoon, Vlahov David, Carpenter Charles C J
Miriam Hospital and dagger Brown University, Providence, Rhode Island 02906, USA.
J Acquir Immune Defic Syndr. 2003 Aug 15;33(5):614-24. doi: 10.1097/00126334-200308150-00011.
To examine factors associated with clinical and immunologic HIV disease progression in a cohort of US women.
Analysis of data from a prospective, longitudinal, case-control study of HIV-infected women followed every 6 months for 7 years.
Four urban clinical centers in the United States.
648 HIV-infected women who did not have AIDS at time of entry into the study.
Structured clinical and behavioral interviews; protocol-directed physical examinations; CD4 lymphocyte counts; plasma HIV RNA; infectious pathogen serologies. RESULTS With 2304 women-years of follow-up, 46.1% of the women developed AIDS; however, 93.3% of the diagnoses were based on CD4 counts dropping to <200 cells/mm(3). Only 10.6% of the women with CD4 counts <200 cells/mm(3) developed an opportunistic infection. Baseline CD4 count was the strongest predictor of subsequent clinical progression. Illicit substance use, multiple pregnancies, demographic variables, and other infections were not associated with progression. Among women with CD4 counts >500 cells/mm(3) at baseline, those who were anemic or had hepatitis C were more likely to progress to AIDS. By the end of the study, only 52% of the participants were on highly active antiretroviral therapy (HAART).
Despite underutilization of HAART in this multicenter cohort of urban women, opportunistic infections were uncommon, despite CD4 declines.
研究美国女性队列中与临床及免疫性HIV疾病进展相关的因素。
对一项前瞻性、纵向、病例对照研究的数据进行分析，该研究对HIV感染女性每6个月随访一次，持续7年。
美国四个城市临床中心。
648名在进入研究时未患艾滋病的HIV感染女性。
结构化临床及行为访谈；按方案进行的体格检查；CD4淋巴细胞计数；血浆HIV RNA；感染性病原体血清学检查。结果 在2304人年的随访中，46.1%的女性发展为艾滋病；然而，93.3%的诊断是基于CD4计数降至<200个细胞/mm³。CD4计数<200个细胞/mm³的女性中只有10.6%发生了机会性感染。基线CD4计数是后续临床进展的最强预测因素。使用违禁药物、多次怀孕、人口统计学变量及其他感染与疾病进展无关。在基线时CD4计数>500个细胞/mm³的女性中，贫血或感染丙型肝炎的女性更易发展为艾滋病。到研究结束时，只有52%的参与者接受了高效抗逆转录病毒治疗（HAART）。
尽管在这个城市女性多中心队列中HAART的使用不足，但尽管CD4计数下降，机会性感染并不常见。
