Erikstrup Christian, Kallestrup Per, Zinyama-Gutsire Rutendo B L, Gomo Exnevia, Lüneborg-Nielsen Margrethe, Gerstoft Jan, Schüpbach Jörg, Ullum Henrik, Katzenstein Terese L
The Centre of Inflammation and Metabolism, Rigshospitalet and Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
J Acquir Immune Defic Syndr. 2008 Jul 1;48(3):345-9. doi: 10.1097/QAI.0b013e31817dc3d1.
Implementation of antiretroviral treatment in sub-Saharan Africa requires efficient tools to monitor HIV patients. p24 measurements have been proposed as an alternative to HIV-RNA because of the low cost of reagents and equipment needed. Here, we evaluate p24 as a prognostic marker in a cohort of HIV-1-infected individuals in Zimbabwe.
Treatment-naive HIV-1-infected individuals (n=198) from the Mupfure Schistosomiasis and HIV Cohort were followed until death or censoring (3-4.3 years). At baseline, p24, HIV-RNA, CD4 cell counts, and clinical staging (Centers for Disease Control and Prevention classification) were assessed.
p24 correlated with HIV-RNA (P<0.0001, R: 0.44). Ten percent of p24 but only 1% of HIV-RNA measurements was undetectable. p24 predicted Centers for Disease Control and Prevention category (P<0.001) stronger than CD4 count (P=0.34) in multivariate logistic regression. p24 predicted mortality in univariate Cox analysis (P<0.0001) and in multivariate analysis, but it was inferior to HIV-RNA and CD4 count.
This is the first study to evaluate the prognostic strength of p24 in an area with a predominance of HIV subtype C infections. p24 correlated with HIV-RNA and predicted clinical stage better than CD4 count. It predicted mortality in both univariate and multivariate analysis, but in multivariate analysis, it was inferior to HIV-RNA and CD4 count.
在撒哈拉以南非洲地区实施抗逆转录病毒治疗需要有效的工具来监测艾滋病毒患者。由于所需试剂和设备成本较低，有人提议将p24检测作为HIV-RNA检测的替代方法。在此，我们在津巴布韦一组感染HIV-1的个体中评估p24作为预后标志物的情况。
对来自穆普富雷血吸虫病与艾滋病毒队列中198例未经治疗的HIV-1感染个体进行随访，直至死亡或失访（3 - 4.3年）。在基线时，评估p24、HIV-RNA、CD4细胞计数和临床分期（疾病控制与预防中心分类）。
p24与HIV-RNA相关（P<0.0001，R：0.44）。10%的p24检测结果不可检测，而HIV-RNA检测结果不可检测的仅为1%。在多变量逻辑回归中，p24对疾病控制与预防中心分类的预测能力（P<0.001）强于CD4细胞计数（P = 0.34）。在单变量Cox分析（P<0.0001）和多变量分析中，p24可预测死亡率，但不如HIV-RNA和CD4细胞计数。
这是第一项在以HIV C亚型感染为主的地区评估p24预后强度的研究。p24与HIV-RNA相关，且在预测临床分期方面优于CD4细胞计数。它在单变量和多变量分析中均能预测死亡率，但在多变量分析中，不如HIV-RNA和CD4细胞计数。
