TY - JOUR
T1 - The relative value of CD4 cell count and quantitative HIV-1 RNA in predicting survival in HIV-1-infected women
T2 - Results of the women's interagency HIV study
AU - Anastos, Kathryn
AU - Kalish, Leslie A.
AU - Hessol, Nancy
AU - Weiser, Barbara
AU - Melnick, Sandra
AU - Burns, David
AU - Delapenha, Robert
AU - DeHovitz, Jack
AU - Cohen, Mardge
AU - Meyer, William
AU - Bremer, James
AU - Kovacs, Andrea
PY - 1999
Y1 - 1999
N2 - Objectives: To determine factors associated with survival and to assess the relative strength of CD4 cell count and HIV-1 RNA in predicting survival in a cohort of HIV-1-infected women. Design: Prospective cohort, enrolled during 1994-1995, with median follow-up of 29 months Results: Of 1769 HIV-infected women 252 died. In multivariate analyses, lower CD4 cell count, higher quantitative plasma HIV-1 RNA, and the presence of a self-reported AIDS-defining (Class C) condition were significantly associated with shorter survival: the relative hazard (RH) of dying was 1.17, 3.27, and 8.46, respectively for women with baseline CD4 cell count of 200-349, 50-199, and < 50 x 106 cells/l, compared with women with CD4 cell count of ≥ 350 x 106 cells/l. Compared with women with HIV-1 RNA levels of < 4000 copies/ml plasma, the RH of dying for women with baseline quantitative HIV-1 RNA measurements of 4000-20,000, 20,000-100,000, 100,000-500,000 and > 500,000 copies/ml, was 2.19, 2.17, 3.16, and 7.25, respectively. CD4 cell count had as strong a prognostic value as HIV-1 RNA level, particularly among participants with more advanced immunodeficiency. When the analysis was adjusted to eliminate the distortion created by having disproportionately sized strata of the categorized variables, the relative hazard of death associated with CD4 cell count became even larger in comparison with that for HIV-1 RNA. Eliminating from the analysis all follow-up time during which participants could have received highly active antiretroviral therapy did not change these findings. Age was not a predictor of survival after adjustment for covariates.
AB - Objectives: To determine factors associated with survival and to assess the relative strength of CD4 cell count and HIV-1 RNA in predicting survival in a cohort of HIV-1-infected women. Design: Prospective cohort, enrolled during 1994-1995, with median follow-up of 29 months Results: Of 1769 HIV-infected women 252 died. In multivariate analyses, lower CD4 cell count, higher quantitative plasma HIV-1 RNA, and the presence of a self-reported AIDS-defining (Class C) condition were significantly associated with shorter survival: the relative hazard (RH) of dying was 1.17, 3.27, and 8.46, respectively for women with baseline CD4 cell count of 200-349, 50-199, and < 50 x 106 cells/l, compared with women with CD4 cell count of ≥ 350 x 106 cells/l. Compared with women with HIV-1 RNA levels of < 4000 copies/ml plasma, the RH of dying for women with baseline quantitative HIV-1 RNA measurements of 4000-20,000, 20,000-100,000, 100,000-500,000 and > 500,000 copies/ml, was 2.19, 2.17, 3.16, and 7.25, respectively. CD4 cell count had as strong a prognostic value as HIV-1 RNA level, particularly among participants with more advanced immunodeficiency. When the analysis was adjusted to eliminate the distortion created by having disproportionately sized strata of the categorized variables, the relative hazard of death associated with CD4 cell count became even larger in comparison with that for HIV-1 RNA. Eliminating from the analysis all follow-up time during which participants could have received highly active antiretroviral therapy did not change these findings. Age was not a predictor of survival after adjustment for covariates.
KW - CD4 cell count
KW - HIV
KW - HIV-1 RNA
KW - Survival
KW - Women
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U2 - 10.1097/00002030-199909100-00016
DO - 10.1097/00002030-199909100-00016
M3 - Article
C2 - 10509574
AN - SCOPUS:0033375084
SN - 0269-9370
VL - 13
SP - 1717
EP - 1726
JO - AIDS
JF - AIDS
IS - 13
ER -