Document 3092
 DOCN  M94A3092
 TI    Prognostic value of HIV-1 biological phenotype for survival after AIDS
       diagnosis.
 DT    9412
 AU    Koot M; van Leeuwen R; Danner S; Schuitemaker H; Tersmette M; Reis P;
       Central Lab. Blood Transf., Amsterdam, The Netherlands.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):155 (abstract no. PB0046). Unique
       Identifier : AIDSLINE ICA10/94369483
 AB    In about 50% of HIV-1 infected persons syncytium inducing (SI) HIV-1
       variants emerge during the asymptomatic phase of infection. The presence
       of SI variants in asymptomatic men is predictive for the progression to
       AIDS, independent of CD4+ T-cell numbers. Here we studied survival among
       AIDS patients in relation to HIV-1 phenotype CD4+ T-cell counts, and P24
       antigenemia. METHODS: In this study we included all AIDS patients (n =
       218) who were diagnosed at the Academic Medical Centre between 1
       December 1985 and 1 December 1989. HIV-1 phenotype was determined by
       cocultivation of cryopreserved PBMC samples with MT-2 cells. RESULTS:
       Median CD4 count at the moment of AIDS diagnosis was 100/mm3. From 178
       out of 218 patients (82%) PBMC samples were available. In 89/178 persons
       (50.0%) SI HIV was detected. There was no significant difference between
       the patients with and without SI variants with respect to the number of
       P24 antigen positive persons or the number of zidovudine treated
       persons. However CD4 counts at the time of AIDS diagnosis were
       significantly lower in persons with SI variants (median: 100/mm3 vs.
       200/mm3, p = 0.003). Zidovudine treatment, low CD4 counts and the
       presence of SI HIV-1 were predictive for decreased survival time in
       univariate cox analysis. Multivariate Cox analysis revealed prognostic
       value for zidovudine treatment and low CD4 counts only. Most (29/30)
       patients without SI HIV at AIDS diagnosis did not develop these variants
       during the final stage of disease. CONCLUSIONS: In agreement with
       previous published results about 50% of patients progressing to AIDS
       harbour SI viruses. These patients have significant lower CD4 counts at
       AIDS diagnosis. In this study population of AIDS patients the prognostic
       value of SI phenotype for survival could be explained by the association
       of SI variants with low CD4 counts at the moment of AIDS diagnosis.
       Emerge of SI variants after AIDS diagnosis was rarely observed even when
       the immune system is severely deteriorated.
 DE    Acquired Immunodeficiency Syndrome/DRUG THERAPY/*MICROBIOLOGY/
       *MORTALITY  Analysis of Variance  Cell Line  Comparative Study  Human
       HIV Core Protein p24/BLOOD  HIV Seropositivity/DRUG
       THERAPY/*MICROBIOLOGY/MORTALITY  HIV-1/*GENETICS/ISOLATION & PURIF
       Leukocyte Count  Lymphocytes/IMMUNOLOGY/MICROBIOLOGY  Multivariate
       Analysis  Phenotype  Predictive Value of Tests  Prognosis  Survival Rate
       T4 Lymphocytes  Zidovudine/THERAPEUTIC USE  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).