Lack of consistency between five definitions of nonprogression in cohorts of HIV-infected seroconverters

被引:36
作者
Strathdee, SA
Veugelers, PJ
PageShafer, KA
McNulty, A
Moss, AR
Schechter, MT
vanGriensven, GP
Coutinho, RA
机构
[1] UNIV BRITISH COLUMBIA,ST PAULS HOSP,DEPT HLTH CARE & EPIDEMIOL,VANCOUVER,BC,CANADA
[2] MUNICIPAL HLTH SERV,AMSTERDAM,NETHERLANDS
[3] UNIV CALIF SAN FRANCISCO,DEPT EPIDEMIOL & BIOSTAT,CTR AIDS PREVENT STUDIES,SAN FRANCISCO,CA 94143
[4] UNIV NEW S WALES,NATL CTR HIV EPIDEMIOL & CLIN RES,SYDNEY,NSW,AUSTRALIA
[5] UNIV CALIF SAN FRANCISCO,SAN FRANCISCO GEN HOSP,DEPT EPIDEMIOL & BIOSTAT,SAN FRANCISCO,CA
关键词
HIV; nonprogressors; homosexual men; seroconverters;
D O I
10.1097/00002030-199610090-00005
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective: To identify appropriate criteria for characterizing HlV-infected nonprogressors. Design: Five definitions were compared as follows: (1) last CD4 count > 500x10(6)/l; (2) two most recent CD4 counts > 500x10(6)/l; (3) calculated CD4 count based on linear regression > 500x10(6)/l; (4) CD4 slope greater than or equal to 0 with no antiretroviral use; (5) all CD4 counts > 500x10(6)/l, decline in CD4 slope < 5 cells per year, no antiretroviral use. Participants: Five prospective cohorts of homosexual men with documented dates of HIV-1 seroconversion. Main outcome measures: Proportions of nonprogressors were calculated 7, 8, 9 and 10 years following seroconversion (n = 285). Definitions were evaluated with respect to consistency over time and across sites. Subjects lacking CD4 counts within 3 years preceding end of follow-up were excluded. Results: Across sites, proportions of nonprogressors ranged from 1% (definition 5) to 17.5% (definition 1) 10 years after seroconversion. Definitions based on absolute CD4 counts (definitions 1-3) had higher proportions and were less consistent than those based on stable slopes (definitions 4 and 5). For each definition, proportions decreased as follow-up increased, but were most stable for definition 4 (3%). Site differences decreased as follow-up increased, but remained nearly threefold for definitions 1-3. None of the definitions classified the same subjects as nonprogressors at any timepoint. Conclusions: Observations regarding nonprogression are highly dependent on the definition and the duration of follow-up. Our findings highlight methodological challenges which will need to be overcome in natural history studies of nonprogression.
引用
收藏
页码:959 / 965
页数:7
相关论文
共 27 条
[1]   HIV-INFECTION IN RECIPIENTS OF BLOOD PRODUCTS FROM DONORS WITH KNOWN DURATION OF INFECTION [J].
ASHTON, LJ ;
LEARMONT, J ;
LUO, K ;
WYLIE, B ;
STEWART, G ;
KALDOR, JM .
LANCET, 1994, 344 (8924) :718-720
[2]   LONG-TERM HIV-1 INFECTION WITHOUT IMMUNOLOGICAL PROGRESSION [J].
BUCHBINDER, SP ;
KATZ, MH ;
HESSOL, NA ;
OMALLEY, PM ;
HOLMBERG, SD .
AIDS, 1994, 8 (08) :1123-1128
[3]   VIROLOGICAL AND IMMUNOLOGICAL CHARACTERIZATION OF LONG-TERM SURVIVORS OF HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION [J].
CAO, YZ ;
QIN, LM ;
ZHANG, LQ ;
SAFRIT, J ;
HO, DD .
NEW ENGLAND JOURNAL OF MEDICINE, 1995, 332 (04) :201-208
[4]   THE MULTICENTER AIDS COHORT STUDY - RETENTION AFTER 9-1/2 YEARS [J].
DUDLEY, J ;
JIN, S ;
HOOVER, D ;
METZ, S ;
THACKERAY, R ;
CHMIEL, J .
AMERICAN JOURNAL OF EPIDEMIOLOGY, 1995, 142 (03) :323-330
[5]   NON-PROGRESSION IN HIV-INFECTION [J].
EASTERBROOK, PJ .
AIDS, 1994, 8 (08) :1179-1182
[6]  
EASTERBROOK PJ, 1994, 4 EUR C CLIN ASP TRE
[7]   VIRUS BURDEN IN LONG-TERM SURVIVORS OF HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) INFECTION IS A DETERMINANT OF ANTI-HIV CD8(+) LYMPHOCYTE ACTIVITY [J].
FERBAS, J ;
KAPLAN, AH ;
HAUSNER, MA ;
HULTIN, LE ;
MATUD, JL ;
LIU, ZY ;
PANICALI, DL ;
NERNGHO, H ;
DETELS, R ;
GIORGI, JV .
JOURNAL OF INFECTIOUS DISEASES, 1995, 172 (02) :329-339
[8]   PREDICTORS FOR NON-PROGRESSION AND SLOW PROGRESSION IN HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) TYPE-1 INFECTION - LOW VIRAL-RNA COPY NUMBERS IN SERUM AND MAINTENANCE OF HIGH HIV-1 P24-SPECIFIC BUT NOT V3-SPECIFIC ANTIBODY-LEVELS [J].
HOGERVORST, E ;
JURRIAANS, S ;
DEWOLF, F ;
VANWIJK, A ;
WIERSMA, A ;
VALK, M ;
ROOS, M ;
VANGEMEN, B ;
COUTINHO, R ;
MIEDEMA, F ;
GOUDSMIT, J .
JOURNAL OF INFECTIOUS DISEASES, 1995, 171 (04) :811-821
[9]   CHARACTERISTICS OF LONG-TERM ASYMPTOMATIC INFECTION WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 IN MEN WITH NORMAL AND LOW CD4+ CELL COUNTS [J].
KEET, IPM ;
KROL, A ;
KLEIN, MR ;
VEUGELERS, P ;
DEWIT, J ;
ROOS, M ;
KOOT, M ;
GOUDSMIT, J ;
MIEDEMA, F ;
COUTINHO, RA .
JOURNAL OF INFECTIOUS DISEASES, 1994, 169 (06) :1236-1243
[10]   LONG-TERM SYMPTOMLESS HIV-1 INFECTION IN RECIPIENTS OF BLOOD PRODUCTS FROM A SINGLE DONOR [J].
LEARMONT, J ;
TINDALL, B ;
EVANS, L ;
CUNNINGHAM, A ;
CUNNINGHAM, P ;
WELLS, J ;
PENNY, R ;
KALDOR, J ;
COOPER, DA .
LANCET, 1992, 340 (8824) :863-867