Zangerle R, Reibnegger G, Wachter H, Fuchs D
Department of Dermatology and Venereology, University, Innsbruck, Austria.
AIDS. 1993 Feb;7(2):175-81. doi: 10.1097/00002030-199302000-00004.
To assess the risk of developing weight loss, a decline in CD4+ T-cell count and AIDS-defining infections using urinary neopterin levels and CD4+ T-cell count.
Retrospective record review.
A primary care clinic for patients at any stage of HIV infection at the University Hospital in Innsbruck, Austria, to which all patients with HIV-related diseases from the Austrian Tyrol are referred.
PATIENTS, PARTICIPANTS: Seventy-nine out of the 311 HIV-seropositive individuals attending our clinic between July 1985 and December 1991 participated in the study. The selection was made after complete examination (clinical and laboratory) and follow-up of at least 6 months, up to 48 months (median, 28 months). Patients with severe diarrhoea were excluded.
Correlation between body mass index, urinary neopterin and CD4+ T-cell count; development of AIDS-defining infections, weight loss, and a decline in CD4+ T-cells. Weight loss was recognized if > 10% of body weight, and there had been no concomitant AIDS-defining infection for at least 2 months.
Initial urinary neopterin (P = 0.04), but not initial CD4+ T-cell count (P = 0.94), correlated with the body mass index obtained at the end of follow-up. Using the product-limit method, urinary neopterin predicted weight loss (P < 0.0001), decline in CD4+ T-cell count to < 200 x 10(6)/l (P = 0.006) and AIDS-defining infections (P = 0.009). CD4+ T-cell count was a better predictor of AIDS-defining infections (P < 0.0001) than of weight loss (P = 0.002). Results were confirmed by multivariate analysis.
Weight loss > 10% of body weight is associated with immune activation.
利用尿新蝶呤水平和CD4+ T细胞计数评估体重减轻、CD4+ T细胞计数下降以及艾滋病界定感染发生的风险。
回顾性记录审查。
奥地利因斯布鲁克大学医院为处于任何HIV感染阶段患者设立的初级保健诊所，奥地利蒂罗尔州所有患有HIV相关疾病的患者均转诊至此。
患者、参与者：1985年7月至1991年12月期间在我们诊所就诊的311名HIV血清阳性个体中有79人参与了该研究。入选是在完成全面检查（临床和实验室）并至少随访6个月、最长48个月（中位数为28个月）后进行的。排除患有严重腹泻的患者。
体重指数、尿新蝶呤与CD4+ T细胞计数之间的相关性；艾滋病界定感染、体重减轻以及CD4+ T细胞减少的发生情况。若体重减轻超过体重的10%且至少2个月内无并发的艾滋病界定感染，则认定为体重减轻。
初始尿新蝶呤水平（P = 0.04）与随访结束时获得的体重指数相关，而初始CD4+ T细胞计数（P = 0.94）与之无关。采用乘积极限法，尿新蝶呤可预测体重减轻（P < 0.0001）、CD4+ T细胞计数降至< 200×10⁶/l（P = 0.006）以及艾滋病界定感染（P = 0.009）。CD4+ T细胞计数对艾滋病界定感染的预测能力（P < 0.0001）优于对体重减轻的预测能力（P = 0.002）。多因素分析证实了结果。
体重减轻超过体重的10%与免疫激活有关。
