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Short-term risk of AIDS in HIV-positive individuals helps guide initiation of therapy
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By Megan Rauscher
NEW YORK (Reuters Health) - Researchers in the UK have used data from the era
before highly active antiretroviral therapy was available to estimate the
short-term (3 to 6 month) risk of the developing AIDS in asymptomatic
HIV-infected individuals.
"Up to now, we have not had estimates available which allow doctors to
actually quantify this risk," Dr. Andrew Phillips from Royal Free & University
College Medical School in London told Reuters Health.
Dr. Phillips, and others with the CASCADE (Concerted Action on SeroConversion
to AIDS and Death in Europe) collaboration, assessed the risk of AIDS in 3226
HIV-infected patients for whom viral load and CD4 cell counts were known
prior to initiation of antiretroviral therapy or during zidovudine monotherapy.
During a total of 5126 person-years of follow-up, 219 subjects developed
AIDS.
According to the team, for subjects with CD4 cell count < 200 cells per
microliter, the risks of developing AIDS in 6 months were 4.9%, 12.7%, 17.7%, and
22.4% for viral loads of <10,000, 10,000-29,999, 30,000-99,999, and >100,000
copies/mL, respectively.
For people with CD4 counts of 200-349 cells per microliter, risks were 0.5%,
1.6%, 3.2%, and 4.7%, respectively for the four viral load groups, while for
those with CD4 counts > 350 cells per microliter, risks were 0.2%, 0.5%, 0.9%
and 2.2%, respectively.
Supporting prior studies, older individuals had higher risk of AIDS for a
given CD4 cell count than younger people, the researchers note in their report in
the January 2nd issue of the journal AIDS.
"This paper," Dr. Phillips commented to Reuters Health, "provides useful
information to doctors who are assessing a patient and wondering whether to start
antiretrovirals or perhaps to wait and re-assess the situation at the
patient's next visit, typically in 3-6 months time."
AIDS 2004;18:51-58.
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