TY - JOUR
T1 - Correlates of the rate of decline of cd4+ lymphocytes among injection drug users infected with the human immunodeficiency virus
AU - Alcabes, Philip
AU - Schoenbaum, Ellie E.
AU - Klein, Robert S.
N1 - Funding Information:
06 from the National Institute on Drug Abuse, by cooperative agreement U64/CCU 200 714-09 from the Centers for Disease Control and Prevention, and by a grant from the Aaron Diamond Foundation.
PY - 1993/5/1
Y1 - 1993/5/1
N2 - Changes in the level of CD4-bearing T-lymphocytes in injection drug users infected with the human immunodeficiency virus were evaluated in a sample of 318 subjects enrolled from a methadone program in the Bronx, New York, from 1985 through 1989. Follow-up continued through 1990. The percentage of CD4+ T-lymphocytes (CD4%) was used to maximize the stability of measurements. The rate of decline of the CD4% was determined using a random-effects assumption, and predictors of rate of decline were evaluated using an autoregressive model. The rate of CD4% decline was approximately 1.2 CD4% lost per 6 months, with a higher rate in recent seroconverters (2.2 CD4% lost). The most important predictors of decline of the CD4% in autoregressive models were current pyogenic bacterial infection (CD4% reduced by 2.75, 95% confidence interval (Cl) 0.42-5.08), current report of a second constitutional symptom (CD4% reduced by 2.16, 95% Cl 0.03-4.29), and history of bacterial infection (CD4% reduced by 1.49, 95% Cl 0.09-2.89; proportion of prior CD4% lost increased by 0.14, 95% Cl 0.01-0.27). Oral thrush was not related to an accelerated rate of CD4% decline.
AB - Changes in the level of CD4-bearing T-lymphocytes in injection drug users infected with the human immunodeficiency virus were evaluated in a sample of 318 subjects enrolled from a methadone program in the Bronx, New York, from 1985 through 1989. Follow-up continued through 1990. The percentage of CD4+ T-lymphocytes (CD4%) was used to maximize the stability of measurements. The rate of decline of the CD4% was determined using a random-effects assumption, and predictors of rate of decline were evaluated using an autoregressive model. The rate of CD4% decline was approximately 1.2 CD4% lost per 6 months, with a higher rate in recent seroconverters (2.2 CD4% lost). The most important predictors of decline of the CD4% in autoregressive models were current pyogenic bacterial infection (CD4% reduced by 2.75, 95% confidence interval (Cl) 0.42-5.08), current report of a second constitutional symptom (CD4% reduced by 2.16, 95% Cl 0.03-4.29), and history of bacterial infection (CD4% reduced by 1.49, 95% Cl 0.09-2.89; proportion of prior CD4% lost increased by 0.14, 95% Cl 0.01-0.27). Oral thrush was not related to an accelerated rate of CD4% decline.
KW - Acquired immunodeficiency syndrome
KW - HIV
KW - T4 lymphocytes
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U2 - 10.1093/oxfordjournals.aje.a116771
DO - 10.1093/oxfordjournals.aje.a116771
M3 - Article
C2 - 8100395
AN - SCOPUS:0027180609
SN - 0002-9262
VL - 137
SP - 989
EP - 1000
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 9
ER -