Author:
LEPRI A. COZZI,SABIN C. A.,PHILLIPS A. N.,LEE C. A.,PEZZOTTI P.,REZZA G.,THE ITALIAN SEROCONVERSION STUDY
Abstract
The data of two cohort studies of HIV-infected individuals
were used to examine whether the
rate of CD4 decline is a determinant of HIV progression, independent of
the most recent CD4
count. Time from seroconversion to clinical AIDS was the main outcome measure.
Rates of
CD4 decline were estimated using the ordinary least squares regression
method. AIDS
incidences were compared in individuals who had previously experienced
either a steeper or a
less steep rate of CD4 decline. Cox proportional hazards model including
a time-dependent
covariate for the rate of CD4 decline was performed. The rate of prior
CD4 decline was
significantly associated with the risk of developing AIDS independently
from the most recent
CD4 count, with a 2% increase in hazard of AIDS (P<·01)
for a difference of 10 cells/mm3 in the estimated yearly
drop
in CD4 count. This finding gives scientific credit to the belief that
individuals with a prior steeper CD4 decline consistently have a higher
subsequent risk of
developing AIDS than those with a less steep prior decline.
Publisher
Cambridge University Press (CUP)
Subject
Infectious Diseases,Epidemiology