Kerlikowske K M, Katz M H, Allen S, Wolf W, Hudes E S, Karita E, Serufilira A, Van de Perre P
General Internal Medicine Section, Department of Veterans Affairs, San Francisco, California.
AIDS. 1994 Jul;8(7):963-9. doi: 10.1097/00002030-199407000-00014.
To determine if beta 2-microglobulin (beta 2M) predicts death among HIV-infected African women.
Nested case-control study.
Kigali, Rwanda.
Two hundred and five seroprevalent women known to be HIV-infected since 1986-1987; 67 of whom died of HIV disease (cases) and 138 were alive (controls) as of November 1991. In addition, 128 women who seroconverted between 1986 and 1991.
HIV serology, clinical signs and symptoms of HIV disease, hematology variables, and beta 2M concentration.
beta 2M concentration increased over time (P < 0.001) in the seroprevalent women and seroconvertors. The average rate of beta 2M increase in women who died was 0.5 compared with 0.3 mg/l/year in the vital, seroprevalent women (P = 0.07). The strongest independent predictors of death were the rate of change of beta 2M (mg/l/year) [odds ratio (OR), 3.4; 95% confidence interval (CI), 1.7-6.8] and baseline beta 2M concentration (mg/l) [OR, 1.6; 95% CI, 1.2-2.1]. The rate of death for women with beta 2M concentration > or = 7.0 mg/l and a rate of change of beta 2M > or = 0.4 mg/l/year was 7.3 times higher than for women with beta 2M concentration < 7.0 mg/l and a rate of change of beta 2M of < 0.4 mg/l/year (95% CI, 3.1-17.2). The estimated median time from seroconversion to death assuming a constant rate of change of beta 2M was 10.6 years (95% CI, 9.9-11.2) for this cohort of HIV-infected women.
Elevated beta 2M and a high rate of beta 2M increase were strongly associated with mortality among HIV-infected African women. Based on survival estimates using the rate of change of beta 2M, HIV-infected African women have similar survival compared with HIV-infected adults in the United States.
确定β2微球蛋白（β2M）是否可预测感染HIV的非洲女性的死亡情况。
巢式病例对照研究。
卢旺达基加利。
205名自1986 - 1987年起已知感染HIV的血清阳性女性；截至1991年11月，其中67人死于HIV相关疾病（病例组），138人存活（对照组）。此外，还有128名在1986年至1991年间血清转化的女性。
HIV血清学、HIV疾病的临床体征和症状、血液学变量以及β2M浓度。
血清阳性女性和血清转化者的β2M浓度随时间升高（P < 0.001）。死亡女性的β2M平均升高速率为0.5，而存活的血清阳性女性为0.3 mg/l/年（P = 0.07）。死亡的最强独立预测因素是β2M的变化速率（mg/l/年）[比值比（OR），3.4；95%置信区间（CI），1.7 - 6.8]和基线β2M浓度（mg/l）[OR，1.6；95% CI，1.2 - 2.1]。β2M浓度≥7.0 mg/l且β2M变化速率≥0.4 mg/l/年的女性的死亡率比β2M浓度<7.0 mg/l且β2M变化速率<0.4 mg/l/年的女性高7.3倍（95% CI，3.1 - 17.2）。对于这组感染HIV的女性，假设β2M变化速率恒定，从血清转化到死亡的估计中位时间为10.6年（95% CI，9.9 - 11.2）。
β2M升高和β2M的高升高速率与感染HIV的非洲女性的死亡率密切相关。根据使用β2M变化速率的生存估计，感染HIV的非洲女性与美国感染HIV的成年人的生存率相似。
