[血浆中p24抗原定量作为251例HIV阳性患者生存预后标志物的价值]
[Value of quantification of p24 antigen in plasma as a prognostic marker of survival in a cohort of 251 HIV-positive patients].
作者信息
Rubio Caballero M, Nogués Biau A, Falguera Sacrest M, Puig Gatnau T, Lorente L
机构信息
Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Lleida.
出版信息
An Med Interna. 1998 Dec;15(12):647-9.
OBJECTIVE
To analyse plasma p24 antigen as a marker of survival in a cohort of HIV-infected patients whose time of seroconversion is unknown.
DESIGN
Prospective cohort study.
SETTING
AIDS Unit in a teaching hospital.
PATIENTS
251 patients were studied, most on antiretroviral therapy. Mean initial CD4 cell counts were 376 x 106/ 1 (range: 0.8-1350). 51 cases had been diagnosed previously with AIDS.
METHODS
Analysis of survival, according to initial plasma p24 antigen was performed by Kaplan-Meier test. Relative risks were calculated by Cox's proportional hazards model.
RESULTS
During a follow-up period of 24 months, 46 patients died. Relative risk (RR) of death related to the group with p24 antigen = < 40 pg/ml was 3.32 when p24 antigen > 40 pg/ml (p = 0.0001). CD4+ cell levels adjusting, the result was 2.47 (CI 95% 1.37-4.46) (p = 0.0027).
CONCLUSIONS
Plasma levels of p24 antigen is useful as a marker of the risk of death and it behaves as a independent prognostic marker in our patients. P24 antigen = < 40 pg/ml is associated with a better prognosis.
目的
分析血浆p24抗原作为一组血清转化时间未知的HIV感染患者生存标志物的情况。
设计
前瞻性队列研究。
地点
一家教学医院的艾滋病科。
患者
对251例患者进行了研究，大多数患者接受抗逆转录病毒治疗。初始CD4细胞计数的平均值为376×10⁶/升（范围：0.8 - 1350）。51例患者先前已被诊断为艾滋病。
方法
通过Kaplan - Meier检验根据初始血浆p24抗原分析生存情况。通过Cox比例风险模型计算相对风险。
结果
在24个月的随访期内，46例患者死亡。当p24抗原>40 pg/ml时，与p24抗原≤40 pg/ml组相关的死亡相对风险（RR）为3.32（p = 0.0001）。调整CD4⁺细胞水平后，结果为2.47（95%置信区间1.37 - 4.46）（p = 0.0027）。
结论
血浆p24抗原水平可作为死亡风险的标志物，并且在我们的患者中是一个独立的预后标志物。p24抗原≤40 pg/ml与较好的预后相关。
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