Veugelers P J, Schechter M T, Tindall B, Moss A R, Page K A, Craib K J, Cooper D A, Coutinho R A, Charlebois E, Winkelstein W
Municipal Health Service, Department of Public Health, Amsterdam, The Netherlands.
AIDS. 1993 Oct;7(10):1325-9. doi: 10.1097/00002030-199310000-00004.
To evaluate the decline in CD4+ counts in relation to the incidence of AIDS in different cohorts of homosexual men and to quantify possible consequences of laboratory variation in CD4+ measurement.
Our study includes 403 men with well documented dates of HIV seroconversion originating from five cohort studies among homosexual men. Differences in time from HIV seroconversion to the first CD4+ count dropping < 500 or 200 x 10(6)/l and to AIDS were evaluated using Kaplan-Meier survival analyses.
We found considerable differences between cohorts in CD4+ depletion, but not in the incidence of AIDS (1987 definition).
Variation in CD4+ depletion appears to be mainly the result of laboratory differences. Policy recommendations on a basis of CD4+ counts probably requires a calibration of measurement. The 1993 AIDS case definition leads to a site-specific shortening of the incubation time, which complicates the study of the natural history of HIV infection and of trends in the AIDS epidemic.
评估不同队列同性恋男性中CD4 +细胞计数下降与艾滋病发病率的关系，并量化CD4 +测量中实验室差异可能产生的后果。
我们的研究纳入了403名有明确记录的HIV血清转化日期的男性，他们来自五项同性恋男性队列研究。使用Kaplan-Meier生存分析评估从HIV血清转化到首次CD4 +细胞计数降至<500或200×10⁶/L以及发展为艾滋病的时间差异。
我们发现不同队列在CD4 +细胞耗竭方面存在显著差异，但在艾滋病发病率（1987年定义）方面没有差异。
CD4 +细胞耗竭的差异似乎主要是实验室差异的结果。基于CD4 +细胞计数的政策建议可能需要对测量进行校准。1993年艾滋病病例定义导致特定部位的潜伏期缩短，这使得对HIV感染自然史和艾滋病流行趋势的研究变得复杂。
