CD4 Cell Count in the Lungs Predict Survival in Asymptomatic HIV
Infection
HIV
RNA levels and CD4 counts in plasma are accepted indicators of severity of illness in patients
with HIV infection. However, CD4 counts in the lungs have not
been evaluated in asymptomatic HIV patients as indicators of HIV
disease stage.
The
purpose of the current study was to determine if lung lymphocyte
counts in asymptomatic subjects with HIV compare with plasma viral
loads and blood CD4 counts in predicting survival.
This
was a retrospective, cross-sectional analysis conducted in a Midwestern
urban community, December 1996 to August 1998.
The
study participants were HIV positive (n = 95) without AIDS-related pulmonary complications.
The
measurements used were plasma viral load, blood hemoglobin and
blood lymphocyte subtypes, lung lymphocyte subtypes from BAL,
body mass index, and mortality.
Results
Eight of the 95 subjects
(8.4%) had died at the 4-year follow-up.
Lung CD4 counts were
significantly related to mortality
by univariable analysis (2.5 x 10(3)/mL vs 0.9 x 10(3)/mL, median
values for survivors vs non survivors, respectively, p = 0.010).
Modeling using exact
methods further showed lung CD4 counts to be a significant predictor
of survival
after individually adjusting for potential
confounders, including plasma viral load and blood CD4 count.
The
authors conclude, “Lung CD4 counts in patients with HIV-1 infection
may provide an independent predictor of survival.”
Davis
Heart and Lung Research Institute, Columbus,
OH.
10/31/05
Reference
M D Wewers and others. Lung CD4 Lymphocytes Predict Survival in
Asymptomatic HIV Infection. Chest 128(4): 2262-2267. October 2005.
