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Laboratory markers associated with progression of HIV infection  [cached]
Gupta V,Gupta S
Indian Journal of Medical Microbiology , 2004,
Abstract: Infection with HIV may develop to AIDS at different rates in different individuals, with a spectrum varying from rapid progression to long term non-progression. The variable course of HIV-1 infection causes emotional trauma for the infected person and complicates the design and interpretation of therapeutic trials because of unrecognized differences in prognosis. Thus it is essential to have tests which can accurately assess the stage of infection in an individual, as well as predict its course and monitor its progression. These laboratory tests are very valuable during the period of clinical latency and subsequently supplement various clinical parameters.
Utility of Serum Neopterin and Serum IL-2 Receptor Levels to Predict Absolute CD4 T Lymphocyte Count in HIV Infected Cases  [PDF]
Sanjim Chadha,Preena Bhalla,Hitender Gautam,Anita Chakravarti,Sanjeev Saini,S. Anuradha,Richa Dewan
Interdisciplinary Perspectives on Infectious Diseases , 2013, DOI: 10.1155/2013/143648
Abstract: A prospective study was carried out to evaluate the efficacy of serum neopterin and soluble IL-2 receptor (sIL-2R) concentrations in comparison to CD4 count to study the progression of HIV disease and monitor response to ART in HIV cases. One hundred newly diagnosed HIV seropositive subjects were recruited. CD4 counts were determined by FACS system. Serum neopterin and sIL-2R levels were measured using enzyme immunoassay. In our study, levels of neopterin and sIL-2R were significantly higher in subjects with CD4 200 cells/μL (with S. neopterin levels of 25.1?nmol/L and sIL-2R levels of 47.1?pM as cutoff values for CD4 200 cells/μL) compared to those in subjects with CD4 200 cells/μL at baseline which indicate that these markers can be utilized for initiation of ART in HIV cases. The levels of these markers decreased significantly after initiation of ART. In patients with CD4 200 cells/μL, these markers are helpful in predicting disease progression. 1. Introduction HIV/AIDS continues to exact an enormous toll throughout the world, in both human and economic terms, posing a serious impediment to the growth and economic stability of many developing countries [1]. Infection with HIV-1 produces a prolonged, gradually progressive disease which leads to opportunistic infections and eventually death. The likelihood and timing of development of clinical AIDS following seroconversion, for any particular individual, are not readily predictable; the use of nonclinical markers has become critically important to patient management. The various phases of HIV infection, including the early asymptomatic phase, are associated with quantifiable laboratory findings. Laboratory surrogate markers of HIV infection, are by definition, measurable traits that correlate with the development of clinical AIDS [2, 3]. The cost of antiretroviral therapy has dramatically reduced and this has led to the increased use of antiretroviral therapy (ART) in developing countries. In view of that, inexpensive laboratory tests are also needed to monitor disease progression and treatment response in HIV infected individuals, living in resource-limited environments most heavily impacted by the epidemic. Currently the standard methods used to monitor HIV infection are clinical assessment, flow cytometry based CD4 T lymphocyte count (CD4 counts) measurement, and molecular assays to quantify plasma viral load (PVL). Though clinical assessment remains the most feasible approach, it lacks sensitivity in determining disease stage, progression, and therapy response; therefore, it is to be used in
Markers, Cofactors and Staging Systems in the Study of HIV Disease Progression: A Review
Memórias do Instituto Oswaldo Cruz , 1997, DOI: 10.1590/S0074-02761997000400001
Abstract: this paper is aimed at providing a comprehensive review of markers, cofactors and staging systems used for hiv disease, focusing on some aspects that nowadays could even be considered historical, and advancing in current issues such as the prognostic value of viral load measurements, viral genotypic and phenotypic characterization, and new hiv disease treatment protocols. cd4+ cell values, combined with the new viral markers mentioned are promising as a parsimonious predictor set for defining both severity and progression. an adequate predictor of patient resource use for planning purposes still needs to be defined
Markers, Cofactors and Staging Systems in the Study of HIV Disease Progression: A Review  [cached]
Portela MC,Simpson KN
Memórias do Instituto Oswaldo Cruz , 1997,
Abstract: This paper is aimed at providing a comprehensive review of markers, cofactors and staging systems used for HIV disease, focusing on some aspects that nowadays could even be considered historical, and advancing in current issues such as the prognostic value of viral load measurements, viral genotypic and phenotypic characterization, and new HIV disease treatment protocols. CD4+ cell values, combined with the new viral markers mentioned are promising as a parsimonious predictor set for defining both severity and progression. An adequate predictor of patient resource use for planning purposes still needs to be defined
Determinants of Progression to AIDS and Death Following HIV Diagnosis: A Retrospective Cohort Study in Wuhan, China  [PDF]
Hongbo Jiang, Nianhua Xie, Beibei Cao, Li Tan, Yunzhou Fan, Fan Zhang, Zhongzhao Yao, Li Liu, Shaofa Nie
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0083078
Abstract: Objective To identify determinants associated with disease progression and death following human immunodeficiency virus (HIV) diagnosis. Methods Disease progression data from the diagnosis of HIV infection or acquiring immunodeficiency syndrome (AIDS) to February 29, 2012 were retrospectively collected from the national surveillance system databases and the national treatment database in Wuhan, China. Kaplan-Meier method, Logistic regression and Cox proportional hazards model were applied to identify the related factors of progression to AIDS or death following HIV diagnosis. Results By the end of February 2012, 181 of 691 HIV infectors developed to AIDS, and 129 of 470 AIDS patients died among whom 289 cases received concurrent HIV/AIDS diagnosis. Compared with men infected through homosexual behavior, injection drug users possessed sharply decreased hazard ratio (HR) for progression to AIDS following HIV diagnosis [HR = 0.31, 95% confidence interval (CI), 0.18–0.54, P = 4.01×10?5]. HIV infectors at least 60 years presented 1.15-fold (HR = 2.15, 95% CI, 1.15–4.03, P = 0.017) increased risk to develop AIDS when compared with those aged 17–29 years. Similarly, AIDS patients with diagnosis ages between 50 and 59 years were at a 1.60-fold higher risk of death (HR = 2.60, 95% CI, 1.18–5.72, P = 0.017) compared to those aged 19–29 years. AIDS patients with more CD4+ T-cells within 6 months at diagnosis (cell/μL) presented lower risk of death (HR = 0.29 for 50- vs <50, 95% CI, 0.15–0.59, P = 0.001). The highly active antiretroviral therapy (HAART) delayed progression to AIDS from HIV diagnosis (HR = 0.15, 95% CI, 0.07–0.34, P = 6.46×10?6) and reduced the risk of death after AIDS diagnosis (HR = 0.02, 95% CI, 0.01–0.04, P = 7.25×10?25). Conclusions Progression to AIDS and death following HIV diagnosis differed in age at diagnosis, transmission categories, CD4+ T-cell counts and HAART. Effective interventions should target those at higher risk for morbidity or mortality, ensuring early diagnosis and timely treatment to slow down the disease progression.
Late HIV Diagnosis and Determinants of Progression to AIDS or Death after HIV Diagnosis among Injection Drug Users, 33 US States, 1996–2004  [PDF]
Anna Grigoryan, H. Irene Hall, Tonji Durant, Xiangming Wei
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0004445
Abstract: Background The timeliness of HIV diagnosis and the initiation of antiretroviral treatment are major determinants of survival for HIV-infected people. Injection drug users (IDUs) are less likely than persons in other transmission categories to seek early HIV counseling, testing, and treatment. Our objective was to estimate the proportion of IDUs with a late HIV diagnosis (AIDS diagnosis within 12 months of HIV diagnosis) and determine the factors associated with disease progression after HIV diagnosis. Methodology/Principal Findings Using data from 33 states with confidential name-based HIV reporting, we determined the proportion of IDUs aged ≥13 years who received a late HIV diagnosis during 1996–2004. We used standardized Kaplan-Meier survival methods to determine differences in time of progression from HIV to AIDS and death, by race/ethnicity, sex, age group, CD4+ T-cell count, metropolitan residence, and diagnosis year. We compared the survival of IDUs with the survival of persons in other transmission categories. During 1996–2004, 42.2% (11,635) of 27,572 IDUs were diagnosed late. For IDUs, the risk for progression from HIV to AIDS 3 years after HIV diagnosis was greater for nonwhites, males and older persons. Three-year survival after HIV diagnosis was lower for IDU males (87.3%, 95% confidence interval (CI), 87.1–87.4) compared with males exposed through male-to-male sexual contact (91.6%, 95% CI, 91.6–91.7) and males exposed through high-risk heterosexual contact (HRHC) (91.9%, 95% CI, 91.8–91.9). Survival was also lower for IDU females (89.5%, 95% CI, 89.4–89.6) compared to HRHC females (93.3%, 95% CI, 93.3–93.4). Conclusions/Significance A substantial proportion of IDUs living with HIV received their HIV diagnosis late. To improve survival of IDUs, HIV prevention efforts must ensure early access to HIV testing and care, as well as encourage adherence to antiretroviral treatment to slow disease progression.
Quantitation of HIV-1 RNA Viral Load Using NASBA Methodology and Comparison with other Surrogate Markers for Disease Progression
Sitnik, Roberta;Rebello Pinho, Jo?o Renato;
Memórias do Instituto Oswaldo Cruz , 1998, DOI: 10.1590/S0074-02761998000300027
Abstract: in this study, hiv-1 viral load quantitation determined by nucleic acid sequence based amplification (nasba) was compared with other surrogate disease progression markers (antigen p24, cd4/cd8 cell counts and b-2 microglobulin) in 540 patients followed up at s?o paulo, sp, brazil. hiv-1 rna detection was statistically associated with the presence of antigen p24, but the viral rna was also detected in 68% of the antigen p24 negative samples, confirming that nasba is much more sensitive than the determination of antigen p24. regarding other surrogate markers, no statistically significant association with the detection of viral rna was found. the reproducibility of this viral load assay was assessed by 14 runs of the same sample, using different reagents batches. viral load values in this sample ranged from 5.83 to 6.27 log (cv = 36 %), less than the range (0.5 log) established to the determination of significant viral load changes.
Quantitation of HIV-1 RNA Viral Load Using NASBA Methodology and Comparison with other Surrogate Markers for Disease Progression  [cached]
Sitnik Roberta,Rebello Pinho Jo?o Renato
Memórias do Instituto Oswaldo Cruz , 1998,
Abstract: In this study, HIV-1 viral load quantitation determined by Nucleic Acid Sequence Based Amplification (NASBA) was compared with other surrogate disease progression markers (antigen p24, CD4/CD8 cell counts and b-2 microglobulin) in 540 patients followed up at S o Paulo, SP, Brazil. HIV-1 RNA detection was statistically associated with the presence of antigen p24, but the viral RNA was also detected in 68% of the antigen p24 negative samples, confirming that NASBA is much more sensitive than the determination of antigen p24. Regarding other surrogate markers, no statistically significant association with the detection of viral RNA was found. The reproducibility of this viral load assay was assessed by 14 runs of the same sample, using different reagents batches. Viral load values in this sample ranged from 5.83 to 6.27 log (CV = 36 %), less than the range (0.5 log) established to the determination of significant viral load changes.
The relationship between nasopharyngeal tonsil size and laboratory markers in children infected with HIV
Zastrow, Michella Dinah;Grando, Liliane Janete;Carvalho, Aroldo Prohmann de;Rath, Inês Beatriz da Silva;Calvo, Maria Cristina;
Revista Odonto Ciência , 2010, DOI: 10.1590/S1980-65232010000300002
Abstract: purpose: the enlargement of nasopharyngeal tonsils, which leads to nasal obstruction and subsequent mouth breathing, can be caused by the presence of hiv. the aim of this research was to study nasopharyngeal tonsil sizes in hiv-infected children ranging from 6 to 13 years and to relate these findings to cd4+ t-cell counts and viral loads. methods: sixty children with hiv (mean age: 9 years and 8 months), infected by vertical transmission, had the sizes of their nasopharynx measured using lateral cephalometric radiographs, specifically focusing on the anatomical areas occupied by the nasopharyngeal tonsils. the children's medical records were analyzed to assess information about tcd4+ lymphocyte count (%) and viral loads (log10). results: the mean value for the nasopharyngeal tonsil size percentage was 70.37%±14.07%. all of the children showed moderate or accentuated hypertrophy of nasopharyngeal tonsils. the average percentage of cd4+ t-cells among the 60 hiv-infected children was 35.01%±10.76%, whereas the mean value for the viral load was 3.35±1.08 log10. conclusion: there was no association between the size percentages of the nasopharyngeal tonsils (calculated against overall nasopharynx sizes) and cd4+ t-cell percentage (r=-0.0136; p=0.298) or the viral load log10 (r=-0.033; p=0.805).
Laboratory and Clinical Predictors of Disease Progression following Initiation of Combination Therapy in HIV-Infected Adults in Thailand  [PDF]
Trinh Duong,Gonzague Jourdain,Nicole Ngo-Giang-Huong,Sophie Le C?ur,Pacharee Kantipong,Sudanee Buranabanjasatean,Prattana Leenasirimakul,Sriprapar Ariyadej,Somboon Tansuphasawasdikul,Suchart Thongpaen,Marc Lallemant
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0043375
Abstract: Data on determinants of long-term disease progression in HIV-infected patients on antiretroviral therapy (ART) are limited in low and middle-income settings.
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