Smith G M, Forbes M A, Cooper J, Bradley T, Hambling M H, Cooper E H, McVerry B A
Department of Haematology, St. James's University Hospital, Leeds.
Clin Lab Haematol. 1991;13(2):115-25. doi: 10.1111/j.1365-2257.1991.tb00260.x.
In February 1986, 40 out of 75 adult patients with haemophilia A attending St. James's University Hospital were human immunodeficiency virus (HIV) antibody positive. Over a three-year period these patients were prospectively studied with regard to possible prognostic indicators for the development of the acquired immune deficiency syndrome (AIDS). Using the Centres for Disease Control (CDC) classification of HIV infection, 17 patients (42.5%) developed group 4 disease during this time, giving an actuarial three-year progression rate of 44%, and 5 patients (12.5%) died. The following parameters measured at recruitment were found independently to predict progression to AIDS: a serum beta 2-m level of greater than 3.5 mg/l, (chi 2 = 15.95, P less than 0.001), a serum IgA level of greater than 4.5 milligram(s) (chi 2 = 6.08, P less than 0.02) and p24 antigenaemia (chi 2 = 5.7, P less than 0.05). The actuarial three-year progression rate in those patients abnormal by two or more of these parameters was 100% (n = 7), compared to only 7% in patients who were normal by all three values (n = 15). CD4+ lymphocyte counts and CD4+:CD8+ ratios were significantly lower in HIV positive compared with HIV negative patients (P less than 0.01), but did not predict the development of AIDS.
1986年2月，在圣詹姆斯大学医院就诊的75例成年甲型血友病患者中，有40例人类免疫缺陷病毒（HIV）抗体呈阳性。在三年期间，对这些患者进行了前瞻性研究，以寻找获得性免疫缺陷综合征（AIDS）发展的可能预后指标。根据疾病控制中心（CDC）对HIV感染的分类，在此期间有17例患者（42.5%）发展为4组疾病，三年精算进展率为44%，5例患者（12.5%）死亡。研究发现，在招募时测量的以下参数可独立预测进展为AIDS：血清β2 - m水平大于3.5mg/l（χ2 = 15.95，P < 0.001）、血清IgA水平大于4.5毫克（χ2 = 6.08，P < 0.02）和p24抗原血症（χ2 = 5.7，P < 0.05）。这些参数中有两项或更多异常的患者，其三年精算进展率为100%（n = 7），而三项指标均正常的患者仅为7%（n = 15）。与HIV阴性患者相比，HIV阳性患者的CD4 +淋巴细胞计数和CD4 +:CD8 +比值显著降低（P < 0.01），但不能预测AIDS的发展。
