Lundgren Jens D, Mocroft Amanda
Copenhagen HIV Programme-044, Hvidovre University Hospital, Hvidovre, Denmark.
Clin Infect Dis. 2003;37 Suppl 4:S297-303. doi: 10.1086/376909.
The prospective, multicenter cohort study EuroSIDA has previously reported on predictors and outcomes of anemia in patients infected with human immunodeficiency virus. In a Cox proportional-hazards model with serial measures of CD4+ cell count, plasma viral load, and degrees of anemia fitted as time-dependent variables, the relative hazard of death increased markedly for patients with anemia versus no anemia. A clinical scoring system was developed and validated for patients receiving highly active antiretroviral therapy using the most recent laboratory measures. Mild and severe anemia were independently (P<.01) associated with clinical disease progression, with a relative hazard of disease progression of 2.2 (95% confidence interval [CI], 1.6-2.9) and 7.1 (95% CI, 2.5-20.1), respectively, compared with patients with no anemia. The mechanisms underlying why hemoglobin is such a strong prognostic marker and whether correction of anemia itself results in a better prognosis remain to be determined.
前瞻性多中心队列研究“欧洲艾滋病临床数据库（EuroSIDA）”此前已报告了人类免疫缺陷病毒感染患者贫血的预测因素和结局。在一个将CD4 +细胞计数、血浆病毒载量和贫血程度的系列测量值作为时间依赖性变量进行拟合的Cox比例风险模型中，贫血患者与无贫血患者相比，死亡的相对风险显著增加。利用最新的实验室测量值，为接受高效抗逆转录病毒治疗的患者开发并验证了一种临床评分系统。轻度和重度贫血分别与临床疾病进展独立相关（P <.01），与无贫血患者相比，疾病进展的相对风险分别为2.2（95%置信区间[CI]，1.6 - 2.9）和7.1（95%CI，2.5 - 20.1）。血红蛋白为何是如此强大的预后标志物以及纠正贫血本身是否会带来更好的预后，其潜在机制仍有待确定。
