Laboratory markers and the risk of developing HIV-1 disease among injecting drug users

Philip Alcabes, Peter A. Selwyn, Katherine Davenny, Diana Hartel, Donna Buono, Ellie Schoenbaum, Robert S. Klein, Gerald H. Friedland

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: To characterize the progression to HIV-1 disease among injecting drug users (IDU) according to laboratory markers. Design: Prospective study of cohort of HIV-1-seroprevalent IDU, with case-comparison component. Methods: Different laboratory markers were examined as predictors of progression to HIV-1-associated diseases including AIDS in a cohort of 318 HIV-1-infected IDU. The cohort was enrolled from a methadone treatment program in the Bronx, New York, USA. The independent utility of non-CD4 cell markers was evaluated after adjustment for the association of low CD4 lymphocyte count with AIDS risk. Clinical events in the natural history of HIV-1 were related to changes in levels of two variables related to duration of infection, CD4 lymphocyte count and serum β2-microglobulin (β2M) concentration. Results: On univariate analysis, AIDS incidence measured from baseline increased with declining CD4 lymphocyte number and percentage, increasing serum β2M level, low platelet count, low leukocyte count and p24 antigenemia. Among HIV-1-related outcomes prior to any AIDS diagnosis, the relative risk of pyogenic bacterial infections conferred by these markers was similar to the relative risk of AIDS. For all HIV-1 outcomes, the elevated risk encountered at CD4 lymphocyte number ≤ 200 x 106/l was entirely due to the high risk at ≤ 150 x 106/l. On multivariate analysis, control for CD4 lymphocyte count eliminated the association of any other marker with increased AIDS hazard. HIV-1-related outcomes tended to occur in this order: multiple constitutional symptoms, oral candidiasis, pyogenic bacterial infections and AIDS. Conclusions: In HIV-1-infected IDU, several laboratory markers may predict AIDS when analyzed individually. These are not, however, independently related to increased AIDS risk after adjustment for low CD4 lymphocyte count. A CD4 count ≤ 150 x 106/l is more strongly related to immediate risk of adverse outcome than a count of 200 x 106/l. A progressive series of clinical events is associated with markers of duration of HIV-1 infection, prior to and including AIDS diagnosis.

Original languageEnglish (US)
Pages (from-to)107-115
Number of pages9
JournalAIDS
Volume8
Issue number1
StatePublished - Jan 1994

Fingerprint

Drug Users
HIV-1
Acquired Immunodeficiency Syndrome
Biomarkers
CD4 Lymphocyte Count
Lymphocyte Count
Bacterial Infections
Oral Candidiasis
Risk Adjustment
Methadone
Natural History
Serum
Platelet Count
Leukocyte Count
HIV Infections
Multivariate Analysis
Prospective Studies
Incidence

Keywords

  • β-microglobulin
  • AIDS
  • CD4 lymphocytes
  • HIV

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Alcabes, P., Selwyn, P. A., Davenny, K., Hartel, D., Buono, D., Schoenbaum, E., ... Friedland, G. H. (1994). Laboratory markers and the risk of developing HIV-1 disease among injecting drug users. AIDS, 8(1), 107-115.

Laboratory markers and the risk of developing HIV-1 disease among injecting drug users. / Alcabes, Philip; Selwyn, Peter A.; Davenny, Katherine; Hartel, Diana; Buono, Donna; Schoenbaum, Ellie; Klein, Robert S.; Friedland, Gerald H.

In: AIDS, Vol. 8, No. 1, 01.1994, p. 107-115.

Research output: Contribution to journalArticle

Alcabes, P, Selwyn, PA, Davenny, K, Hartel, D, Buono, D, Schoenbaum, E, Klein, RS & Friedland, GH 1994, 'Laboratory markers and the risk of developing HIV-1 disease among injecting drug users', AIDS, vol. 8, no. 1, pp. 107-115.
Alcabes, Philip ; Selwyn, Peter A. ; Davenny, Katherine ; Hartel, Diana ; Buono, Donna ; Schoenbaum, Ellie ; Klein, Robert S. ; Friedland, Gerald H. / Laboratory markers and the risk of developing HIV-1 disease among injecting drug users. In: AIDS. 1994 ; Vol. 8, No. 1. pp. 107-115.
@article{f9ff2332a3f54118a716bccb3602223a,
title = "Laboratory markers and the risk of developing HIV-1 disease among injecting drug users",
abstract = "Objective: To characterize the progression to HIV-1 disease among injecting drug users (IDU) according to laboratory markers. Design: Prospective study of cohort of HIV-1-seroprevalent IDU, with case-comparison component. Methods: Different laboratory markers were examined as predictors of progression to HIV-1-associated diseases including AIDS in a cohort of 318 HIV-1-infected IDU. The cohort was enrolled from a methadone treatment program in the Bronx, New York, USA. The independent utility of non-CD4 cell markers was evaluated after adjustment for the association of low CD4 lymphocyte count with AIDS risk. Clinical events in the natural history of HIV-1 were related to changes in levels of two variables related to duration of infection, CD4 lymphocyte count and serum β2-microglobulin (β2M) concentration. Results: On univariate analysis, AIDS incidence measured from baseline increased with declining CD4 lymphocyte number and percentage, increasing serum β2M level, low platelet count, low leukocyte count and p24 antigenemia. Among HIV-1-related outcomes prior to any AIDS diagnosis, the relative risk of pyogenic bacterial infections conferred by these markers was similar to the relative risk of AIDS. For all HIV-1 outcomes, the elevated risk encountered at CD4 lymphocyte number ≤ 200 x 106/l was entirely due to the high risk at ≤ 150 x 106/l. On multivariate analysis, control for CD4 lymphocyte count eliminated the association of any other marker with increased AIDS hazard. HIV-1-related outcomes tended to occur in this order: multiple constitutional symptoms, oral candidiasis, pyogenic bacterial infections and AIDS. Conclusions: In HIV-1-infected IDU, several laboratory markers may predict AIDS when analyzed individually. These are not, however, independently related to increased AIDS risk after adjustment for low CD4 lymphocyte count. A CD4 count ≤ 150 x 106/l is more strongly related to immediate risk of adverse outcome than a count of 200 x 106/l. A progressive series of clinical events is associated with markers of duration of HIV-1 infection, prior to and including AIDS diagnosis.",
keywords = "β-microglobulin, AIDS, CD4 lymphocytes, HIV",
author = "Philip Alcabes and Selwyn, {Peter A.} and Katherine Davenny and Diana Hartel and Donna Buono and Ellie Schoenbaum and Klein, {Robert S.} and Friedland, {Gerald H.}",
year = "1994",
month = "1",
language = "English (US)",
volume = "8",
pages = "107--115",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Laboratory markers and the risk of developing HIV-1 disease among injecting drug users

AU - Alcabes, Philip

AU - Selwyn, Peter A.

AU - Davenny, Katherine

AU - Hartel, Diana

AU - Buono, Donna

AU - Schoenbaum, Ellie

AU - Klein, Robert S.

AU - Friedland, Gerald H.

PY - 1994/1

Y1 - 1994/1

N2 - Objective: To characterize the progression to HIV-1 disease among injecting drug users (IDU) according to laboratory markers. Design: Prospective study of cohort of HIV-1-seroprevalent IDU, with case-comparison component. Methods: Different laboratory markers were examined as predictors of progression to HIV-1-associated diseases including AIDS in a cohort of 318 HIV-1-infected IDU. The cohort was enrolled from a methadone treatment program in the Bronx, New York, USA. The independent utility of non-CD4 cell markers was evaluated after adjustment for the association of low CD4 lymphocyte count with AIDS risk. Clinical events in the natural history of HIV-1 were related to changes in levels of two variables related to duration of infection, CD4 lymphocyte count and serum β2-microglobulin (β2M) concentration. Results: On univariate analysis, AIDS incidence measured from baseline increased with declining CD4 lymphocyte number and percentage, increasing serum β2M level, low platelet count, low leukocyte count and p24 antigenemia. Among HIV-1-related outcomes prior to any AIDS diagnosis, the relative risk of pyogenic bacterial infections conferred by these markers was similar to the relative risk of AIDS. For all HIV-1 outcomes, the elevated risk encountered at CD4 lymphocyte number ≤ 200 x 106/l was entirely due to the high risk at ≤ 150 x 106/l. On multivariate analysis, control for CD4 lymphocyte count eliminated the association of any other marker with increased AIDS hazard. HIV-1-related outcomes tended to occur in this order: multiple constitutional symptoms, oral candidiasis, pyogenic bacterial infections and AIDS. Conclusions: In HIV-1-infected IDU, several laboratory markers may predict AIDS when analyzed individually. These are not, however, independently related to increased AIDS risk after adjustment for low CD4 lymphocyte count. A CD4 count ≤ 150 x 106/l is more strongly related to immediate risk of adverse outcome than a count of 200 x 106/l. A progressive series of clinical events is associated with markers of duration of HIV-1 infection, prior to and including AIDS diagnosis.

AB - Objective: To characterize the progression to HIV-1 disease among injecting drug users (IDU) according to laboratory markers. Design: Prospective study of cohort of HIV-1-seroprevalent IDU, with case-comparison component. Methods: Different laboratory markers were examined as predictors of progression to HIV-1-associated diseases including AIDS in a cohort of 318 HIV-1-infected IDU. The cohort was enrolled from a methadone treatment program in the Bronx, New York, USA. The independent utility of non-CD4 cell markers was evaluated after adjustment for the association of low CD4 lymphocyte count with AIDS risk. Clinical events in the natural history of HIV-1 were related to changes in levels of two variables related to duration of infection, CD4 lymphocyte count and serum β2-microglobulin (β2M) concentration. Results: On univariate analysis, AIDS incidence measured from baseline increased with declining CD4 lymphocyte number and percentage, increasing serum β2M level, low platelet count, low leukocyte count and p24 antigenemia. Among HIV-1-related outcomes prior to any AIDS diagnosis, the relative risk of pyogenic bacterial infections conferred by these markers was similar to the relative risk of AIDS. For all HIV-1 outcomes, the elevated risk encountered at CD4 lymphocyte number ≤ 200 x 106/l was entirely due to the high risk at ≤ 150 x 106/l. On multivariate analysis, control for CD4 lymphocyte count eliminated the association of any other marker with increased AIDS hazard. HIV-1-related outcomes tended to occur in this order: multiple constitutional symptoms, oral candidiasis, pyogenic bacterial infections and AIDS. Conclusions: In HIV-1-infected IDU, several laboratory markers may predict AIDS when analyzed individually. These are not, however, independently related to increased AIDS risk after adjustment for low CD4 lymphocyte count. A CD4 count ≤ 150 x 106/l is more strongly related to immediate risk of adverse outcome than a count of 200 x 106/l. A progressive series of clinical events is associated with markers of duration of HIV-1 infection, prior to and including AIDS diagnosis.

KW - β-microglobulin

KW - AIDS

KW - CD4 lymphocytes

KW - HIV

UR - http://www.scopus.com/inward/record.url?scp=0028268153&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028268153&partnerID=8YFLogxK

M3 - Article

C2 - 7912083

AN - SCOPUS:0028268153

VL - 8

SP - 107

EP - 115

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 1

ER -