       Document 0787
 DOCN  M9610787
 TI    The predictive value of changes in serologic and cell markers of HIV
       activity for subsequent clinical outcome in patients with asymptomatic
       HIV disease treated with zidovudine.
 DT    9601
 AU    Jacobson MA; De Gruttola V; Reddy M; Arduino JM; Strickland S; Reichman
       RC; Bartlett JA; Phair JP; Hirsch MS; Collier AC; et al; Department of
       Medicine, University of California, San Francisco; General Hospital
       94110, USA.
 SO    AIDS. 1995 Jul;9(7):727-34. Unique Identifier : AIDSLINE MED/96035236
 AB    OBJECTIVE: To determine if serologic marker responses to zidovudine
       treatment during the first year of antiretroviral therapy could predict
       subsequent HIV disease progression independently of absolute CD4
       lymphocyte responses. METHODS: We conducted a case-control study in
       patients with asymptomatic HIV disease, who were initiating zidovudine
       therapy in a randomized, prospective trial. A total of 102 patients who
       progressed to AIDS or advanced AIDS-related complex and 177 randomly
       selected controls matched by baseline CD4 cell count and duration of
       follow-up had serum samples (from prior to and at 8, 16, 32 and 48 weeks
       of zidovudine treatment) assayed for acid-disassociated HIV p24 antigen,
       beta 2-microglobulin (beta 2M), neopterin, soluble interleukin (IL)-2
       receptor, soluble CD4 protein and soluble CD8 protein. RESULTS: Median
       time to event for cases was 20.2 months; median follow-up on study was
       35.4 months for controls. After controlling for absolute CD4 count at
       baseline, increased baseline serum concentrations of HIV p24 antigen,
       beta 2M, neopterin, and soluble IL-2 receptor were highly predictive of
       increased risk of HIV disease progression. In a multiple logistic
       regression model, controlling for baseline marker values, change in beta
       2M consistently added independent value to change in CD4 count in
       predicting subsequent risk of disease progression. CONCLUSIONS:
       Monitoring serum immunologic markers, in particular beta 2M, in addition
       to absolute CD4 lymphocyte counts prior to and within the first 4 months
       after initiating dideoxynucleoside therapy can increase the accuracy of
       estimations of subsequent long-term risk of clinical HIV disease
       progression. This information may be useful to clinicians and patients
       who are making decisions about initiating or changing antiretroviral
       therapy.
 DE    Acquired Immunodeficiency Syndrome/*DRUG THERAPY/VIROLOGY  Adult
       Antiviral Agents/*THERAPEUTIC USE  AIDS-Related Complex/*DRUG
       THERAPY/VIROLOGY  Case-Control Studies  CD4 Lymphocyte Count
       Double-Blind Method  Female  Human  HIV Seropositivity/DRUG THERAPY
       Male  Predictive Value of Tests  Support, U.S. Gov't, P.H.S.  Treatment
       Outcome  Zidovudine/*THERAPEUTIC USE  CLINICAL TRIAL  JOURNAL ARTICLE
       RANDOMIZED CONTROLLED TRIAL

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

