HIV-1 subtype E progression among northern Thai couples: traditional and non-traditional predictors of survival

C Costello; K E Nelson; V Suriyanon; S Sennun; S Tovanabutra; C M Heilig; S Shiboski; D J Jamieson; V Robison; K Rungruenthanakit; A Duerr

doi:10.1093/ije/dyi023

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HIV-1 subtype E progression among northern Thai couples: traditional and non-traditional predictors of survival

Journal article

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HIV-1 subtype E progression among northern Thai couples: traditional and non-traditional predictors of survival

C Costello, K E Nelson, V Suriyanon, S Sennun, S Tovanabutra, C M Heilig, S Shiboski, D J Jamieson, V Robison, K Rungruenthanakit, …

International journal of epidemiology, Vol.34(3), pp.577-584

06/2005

DOI: 10.1093/ije/dyi023

PMID: 15737969

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Abstract

Background In the continuing effort to introduce antiretroviral therapy in resource-limited settings, there is a need to understand differences between natural history of HIV in different populations and to identify feasible clinical measures predictive of survival. Methods We examined predictors of survival among 836 heterosexuals who were infected with HIV subtype CRF01_AE in Thailand. Results From 1993 to 1999, 269 (49.4%) men and 65 (25.7%) women died. The median time from the estimated seroconversion to death was 7.8 years (95% confidence interval 7.0–9.1). Men and women with enrolment CD4 counts <200 cells/μl had about 2 and 11 times greater risk of death than those with CD4 counts of 200–500 and >500, respectively. Measurements available in resource-limited settings, including total lymphocyte count (TLC), anaemia, and low body mass index (BMI), also predicted survival. Men with two or more of these predictors had a median survival of 0.8 (0.5–1.8) years, compared with 2.7 (1.9–3.3) years for one predictor and 4.9 (4.1–5.2) years for no predictors. Conclusions The time from HIV infection to death appears shorter among this Thai population than among antiretroviral naïve Western populations. CD4 count and viral load (VL) were strong, independent predictors of survival. When CD4 count and VL are unavailable, individuals at high risk for shortened HIV survival may be identified by a combination of low TLC, anaemia, and low BMI. This combination of accessible clinical measures of the disease stage may be useful for medical management in resource-limited settings.

CD4 lymphocyte count

HIV-1

lymphocyte count

survival

Thailand

viral load

Details

Title: Subtitle: HIV-1 subtype E progression among northern Thai couples: traditional and non-traditional predictors of survival
Creators: C Costello - Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, USA
K E Nelson - Johns Hopkins University
V Suriyanon - Johns Hopkins University
S Sennun - Johns Hopkins University
S Tovanabutra - Henry M. Jackson Foundation
C M Heilig - Centers for Disease Control and Prevention
S Shiboski - University of California at San Francisco, San Francisco, CA 94143, USA
D J Jamieson - Centers for Disease Control and Prevention
V Robison - Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, USA
K Rungruenthanakit - Chiang Mai University
A Duerr - Centers for Disease Control and Prevention
Resource Type: Journal article
Publication Details: International journal of epidemiology, Vol.34(3), pp.577-584
Publisher: Oxford University Press
DOI: 10.1093/ije/dyi023
PMID: 15737969
ISSN: 0300-5771
eISSN: 1464-3685
Language: English
Date published: 06/2005
Academic Unit: Obstetrics and Gynecology; VPMA - Administration
Record Identifier: 9984446417502771

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