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p24 as a predictor of mortality in a cohort of HIV-1-infected adults in rural Africa

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Christian Erikstrup
  • Per Kallestrup
  • Rutendo B L Zinyama-Gutsire
  • Exnevia Gomo
  • Margrethe Lüneborg-Nielsen
  • Gerstoft, Jan
  • Jörg Schüpbach
  • Ullum, Henrik
  • Terese L Katzenstein

BACKGROUND: Implementation of antiretroviral treatment in sub-Saharan Africa requires efficient tools to monitor HIV patients. p24 measurements have been proposed as an alternative to HIV-RNA because of the low cost of reagents and equipment needed. Here, we evaluate p24 as a prognostic marker in a cohort of HIV-1-infected individuals in Zimbabwe.

METHODS: Treatment-naive HIV-1-infected individuals (n=198) from the Mupfure Schistosomiasis and HIV Cohort were followed until death or censoring (3-4.3 years). At baseline, p24, HIV-RNA, CD4 cell counts, and clinical staging (Centers for Disease Control and Prevention classification) were assessed.

RESULTS: p24 correlated with HIV-RNA (P<0.0001, R: 0.44). Ten percent of p24 but only 1% of HIV-RNA measurements was undetectable. p24 predicted Centers for Disease Control and Prevention category (P<0.001) stronger than CD4 count (P=0.34) in multivariate logistic regression. p24 predicted mortality in univariate Cox analysis (P<0.0001) and in multivariate analysis, but it was inferior to HIV-RNA and CD4 count.

CONCLUSIONS: This is the first study to evaluate the prognostic strength of p24 in an area with a predominance of HIV subtype C infections. p24 correlated with HIV-RNA and predicted clinical stage better than CD4 count. It predicted mortality in both univariate and multivariate analysis, but in multivariate analysis, it was inferior to HIV-RNA and CD4 count.

OriginalsprogEngelsk
TidsskriftJournal of acquired immune deficiency syndromes (1999)
Vol/bind48
Udgave nummer3
Sider (fra-til)345-9
Antal sider5
ISSN1525-4135
DOI
StatusUdgivet - 1 jul. 2008

ID: 180571121