Zangerle R, Fuchs D, Reibnegger G, Fritsch P, Wachter H
Department of Dermatology and Venerology, University of Innsbruck, Austria.
AIDS. 1991 Aug;5(8):985-91. doi: 10.1097/00002030-199108000-00010.
We evaluated the number and percentage of CD4+ T cells, the ratio of CD4+ T cells to CD8+ T cells, the serum levels of beta 2- microglobulin and urinary levels of neopterin for their ability to predict disease progression (defined as clinical AIDS and/or oral candidiasis in combination with a CD4+ T cell count less than 400 x 10(6)/l). Thirty-eight intravenous drug users (IVDU) infected with HIV-1 without HIV-1-related symptoms were followed for a median observation period of 45 months. Cumulative incidence of disease progression was computed by the product-limit approach. The CD4+: CD8+ T-cell ratio (P = 0.001), the number (P = 0.002) and percentage (P = 0.05) of CD4+ T cells, and urinary neopterin (P = 0.007) were significant predictors for disease progression. Serum beta 2-microglobulin, which has been found to be of similar prognostic value as neopterin in homosexual men, did not show predictive power in this study of IVDU. The urinary neopterin concentrations obtained at entry of the study correlated with the values of the CD4+:CD8+ T-cell ratio and number and percentage of CD4+ T cells which were obtained at the end of the follow-up. These findings should help to identify, among HIV-1-infected IVDU, those at high risk of disease progression.
我们评估了CD4+ T细胞的数量和百分比、CD4+ T细胞与CD8+ T细胞的比例、血清β2-微球蛋白水平以及尿新蝶呤水平预测疾病进展（定义为临床艾滋病和/或口腔念珠菌病合并CD4+ T细胞计数低于400×10⁶/L）的能力。38名感染HIV-1但无HIV-1相关症状的静脉吸毒者（IVDU）被随访，中位观察期为45个月。疾病进展的累积发病率采用乘积限法计算。CD4+:CD8+ T细胞比例（P = 0.001）、CD4+ T细胞数量（P = 0.002）和百分比（P = 0.05）以及尿新蝶呤（P = 0.007）是疾病进展的显著预测指标。血清β2-微球蛋白在同性恋男性中已被发现与新蝶呤具有相似的预后价值，但在这项IVDU研究中未显示出预测能力。研究开始时测得的尿新蝶呤浓度与随访结束时测得的CD4+:CD8+ T细胞比例、CD4+ T细胞数量和百分比的值相关。这些发现应有助于在感染HIV-1的IVDU中识别出疾病进展高风险者。
