Document 0258
 DOCN  M95A0258
 TI    Distribution of CD4+ T lymphocytes at diagnosis of acquired
       immunodeficiency syndrome-defining and other human immunodeficiency
       virus-related illnesses. The Adult and Adolescent Spectrum of HIV
       Disease Project Group.
 DT    9510
 AU    Hanson DL; Chu SY; Farizo KM; Ward JW; Division of HIV/AIDS, Centers for
       Disease Control, Atlanta, Ga.,; USA.
 SO    Arch Intern Med. 1995 Jul 24;155(14):1537-42. Unique Identifier :
       AIDSLINE MED/95328903
 AB    BACKGROUND: Depletion of circulating CD4+ T lymphocytes among persons
       infected with the human immunodeficiency virus (HIV) is associated with
       increased risk for development of opportunistic, life-threatening
       diseases and death. METHODS: To describe the levels of CD4+ T
       lymphocytes at which acquired immunodeficiency syndrome (AIDS)-defining
       and other illnesses initially occur, we analyzed data from an ongoing
       survey of medical records of 18,062 HIV-infected patients who received
       medical care between January 1990 and August 1993 in more than 100
       clinics, hospitals, and private practices in 10 US cities. We report the
       median and upper 80th percentile CD4+ T-lymphocyte counts at diagnosis.
       RESULTS: We found that AIDS-defining conditions first occurred in
       HIV-infected patients with CD4+ T-lymphocyte counts below 0.20 x 10(9)/L
       (200/microL) for 80% of diagnoses. Similarly, AIDS-defining diseases
       occurred at counts below 0.05 x 10(9)/L for 50% of diagnoses. Exceptions
       to both criteria were invasive cervical cancer and pulmonary
       tuberculosis. Non-AIDS-defining illnesses with which 80% of patients
       were diagnosed at CD4+ T-lymphocyte counts below 0.20 x 10(9)/L were
       bacterial sepsis and retinopathy (excluding cytomegalovirus).
       CONCLUSION: Our observations support the need for continued CD4+ cell
       count monitoring below a level of 0.20 x 10(9)/L as a guide to diagnosis
       and medical management of HIV-infected persons.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DIAGNOSIS/
       *IMMUNOLOGY  Adolescence  Adult  Aged  Aged, 80 and over  AIDS-Related
       Opportunistic Infections/IMMUNOLOGY  *CD4-Positive T-Lymphocytes  Female
       Human  Lymphocyte Count  Male  Middle Age  Neoplasms/IMMUNOLOGY/VIROLOGY
       JOURNAL ARTICLE

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