Reid M J, Goetz D W, Zajac R A, Houk R W, Boswell R N
Department of Medicine, Wilford Hall USAF Medical Center, Lackland AFB, San Antonio, TX 78236.
J Acquir Immune Defic Syndr (1988). 1988;1(5):508-15.
We prospectively studied 157 HIV antibody-positive U.S. Air Force personnel identified by universal ELISA screening and confirmed by Western blot. They were initially evaluated and then re-evaluated at least once at approximately 1 year intervals. In order to determine which if any demographic and serologic cofactors were significantly related to progression of immunodeficiency early in the course of disease, we compared these variables with the mean change in CD4 cells per month and with progression in Walter Reed stage. Upon entry into the study, the subjects were classified as follows: sex: 153 (97.5%) male, 4 (2.5%) female; race: 84 (53.5%) white, 63 (40.1%) black, 8 (5.1%) Hispanic, and 2 (1.3%) Oriental; age: mean of 28.6 years (63.0% between 20 and 32 years); and Walter Reed stage: 108 (68.8%) Walter Reed 1, 26 (16.6%) Walter Reed 2, 9 (5.7%) Walter Reed 3, 6 (3.8%) Walter Reed 4, 5 (3.2%) Walter Reed 5, and 3 (1.9%) Walter Reed 6. The mean follow-up period was 12.2 months (range of 2 to 35 months). The mean change in CD4 cells per month was -0.072 (range of -94.75 to +67.58). Factors at entry that are significantly related to loss of CD4 cells included serum IgA over 300 mg/dl (p = 0.0450) and anergy (p = 0.0093). Factors at entry significantly related to progression in Walter Reed stage included serum IgA over 300 mg/dl (p = 0.0001), low absolute CD4 count (p = 0.0001), and low CD4/CD8 ratio (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
我们对157名通过通用酶联免疫吸附测定（ELISA）筛查并经蛋白质印迹法确认的美国空军HIV抗体阳性人员进行了前瞻性研究。他们最初接受了评估，然后大约每隔1年至少重新评估一次。为了确定哪些人口统计学和血清学辅助因素与疾病早期免疫缺陷的进展显著相关，我们将这些变量与每月CD4细胞的平均变化以及沃尔特·里德分期的进展情况进行了比较。进入研究时，受试者分类如下：性别：153名（97.5%）男性，4名（2.5%）女性；种族：84名（53.5%）白人，63名（40.1%）黑人，8名（5.1%）西班牙裔，2名（1.3%）亚裔；年龄：平均28.6岁（63.0%在20至32岁之间）；沃尔特·里德分期：108名（68.8%）沃尔特·里德1期，26名（16.6%）沃尔特·里德2期，9名（5.7%）沃尔特·里德3期，6名（3.8%）沃尔特·里德4期，5名（3.2%）沃尔特·里德5期，3名（1.9%）沃尔特·里德6期。平均随访期为12.2个月（范围为2至35个月）。每月CD4细胞的平均变化为-0.072（范围为-94.75至+67.58）。进入研究时与CD4细胞减少显著相关的因素包括血清IgA超过300 mg/dl（p = 0.0450）和无反应性（p = 0.0093）。进入研究时与沃尔特·里德分期进展显著相关的因素包括血清IgA超过300 mg/dl（p = 0.0001）、CD4细胞绝对计数低（p = 0.0001）和CD4/CD8比值低（p = 0.0001）。（摘要截短于250字）
