Serum anti-p24 antibody concentration has a predictive value on the decrease of CD4 lymphocyte count higher than acid-dissociated p24 antigen

1995 ◽  
Vol 47 (1) ◽  
pp. 87-91 ◽  
Author(s):  
L. Morand-Joubert ◽  
H. Bludau ◽  
J. Lerable ◽  
J. C. Petit ◽  
J. J. Lefrère
Keyword(s):  
Predictive Value ◽  
Lymphocyte Count ◽  
Antibody Concentration ◽  
Cd4 Lymphocyte Count ◽  
P24 Antigen ◽  
Cd4 Lymphocyte

Surrogate Markers for Assessing Treatment Response in HIV Disease

1993 ◽  
Vol 27 (4) ◽  
pp. 450-455 ◽  
Author(s):  
Dennis F. Thompson ◽  
Marsha A. Raebel ◽  
R. Chris Rathbun
Keyword(s):  
Clinical Trials ◽  
Hiv Infection ◽  
Treatment Response ◽  
Lymphocyte Count ◽  
Interleukin 2 ◽  
Surrogate Markers ◽  
Hiv Disease ◽  
Cd4 Lymphocyte Count ◽  
P24 Antigen ◽  
Cd4 Lymphocyte

OBJECTIVE: To provide an awareness of the issues surrounding the selection and utility of surrogate markers to evaluate treatment response for new antiretroviral therapies for HIV infection. DATA SOURCES: A MEDLINE search of applicable articles published between 1987 to the present, including clinical trials, commentaries, and editorials, was performed. DATA SYNTHESIS: Surrogate markers are proximal indicators that are predictive of rare or distant outcomes and can be used in clinical trials to decrease sample size and study duration, Characteristics of potential surrogate endpoints include relevance to disease state, face validity, ability to be detected in the majority of patients, and correlation between treatment-induced changes and terminal endpoints. Potential surrogate markers for assessing treatment response in HIV infection can be categorized as either virologic (p24 antigen, plasma viremia, proviral DNA) or immunologic (CD4+ lymphocytes, neopterin, beta2-microglobulin, soluble interleukin-2 receptors, immunoglobulin A [IgA]). The CD4+ lymphocyte count and the p24 antigen have been evaluated in most of the clinical trials examining antiretroviral agents and have the greatest documentation supporting their use. Neopterin and beta2-microglobulin are nonspecific markers, but may improve the predictive value of the CD4+ count when used in combination. Other markers (i.e., soluble interleukin-2 receptors, IgA) remain relatively unstudied at this point. CONCLUSIONS: There is no current consensus regarding the selection of surrogate markers for HIV disease. On the basis of the present literature, the CD4+ lymphocyte count has the greatest endorsement; however, combination with several surrogate markers may prove to be useful in clinical trials. Studies are needed to verify the reliability of surrogate markers used alone and in combination to predict therapeutic response from antiretro viral therapy.

Combination Therapy With Stavudine and Didanosine in Children With Advanced Human Immunodeficiency Virus Infection: Pharmacokinetic Properties, Safety, and Immunologic and Virologic Effects

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 886-890
Author(s):  
Mark W. Kline ◽  
Courtney V. Fletcher ◽  
Marianne E. Federici ◽  
Alice T. Harris ◽  
Kim D. Evans ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Combination Therapy ◽  
Lymphocyte Count ◽  
Hiv Disease ◽  
Hiv Rna ◽  
Immunodeficiency Virus ◽  
Pharmacokinetic Properties ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte ◽  
Advanced Hiv Disease

Objectives. To obtain preliminary information on the pharmacokinetic properties, tolerance, safety, and antiviral activity of combination therapy with stavudine and didanosine in children with advanced human immunodeficiency virus (HIV) infection. Methods. Eight children (median age, 6.6 years; range, 2.8 to 12 years) with advanced HIV disease (median CD4+ lymphocyte count at baseline, 42 cells/µL; range, 8 to 553 cells/µL) were treated with stavudine (2 mg/kg per day in two divided doses) and didanosine (180 mg/m2 per day in two divided doses) for 24 weeks. Seven children had histories of prior zidovudine therapy. All children had received stavudine alone for 19 to 33 months before the addition of didanosine to the treatment regimen. Children were assessed clinically and with laboratory studies at baseline, weekly through week 4 of combination therapy, and every 4 weeks thereafter. Results. Analysis of stavudine and didanosine plasma half-life values, clearances, and area under the plasma concentration-versus-time curves revealed no obvious clinical pharmacokinetic interaction between the drugs through study week 12. Combination therapy was well tolerated, and there were no drug-associated clinical or laboratory adverse events. Signs and symptoms of peripheral neuropathy were not observed. All three children with baseline CD4+ lymphocyte counts greater than 50 cells/µL had greater than 20% increases in their counts within the first 12 weeks of therapy; CD4+ lymphocyte count increases were not observed in the other children. Plasma HIV RNA concentrations showed median declines of 0.88 log10 (range, -3.41 log10 to 0.31 log10) and 0.30 log10 (range, -0.63 log10 to 0.89 log10) at study weeks 12 and 24, respectively. Conclusions. Combination therapy with stavudine and didanosine was well tolerated and safe in this small group of children with advanced HIV disease. Plasma HIV RNA concentration declines suggest a favorable effect of therapy on virus load. These findings should be confirmed, and the regimen's clinical efficacy should be examined, in controlled studies of HIV-infected children with less-advanced disease.

Predicting CD4 Lymphocyte Count <200 Cells/mm3 in an HIV Type 1-Infected African Population

2007 ◽  
Vol 23 (10) ◽  
pp. 1230-1236 ◽  
Author(s):  
Susan C. Morpeth ◽  
John A. Crump ◽  
Humphrey J. Shao ◽  
Habib O. Ramadhani ◽  
Peter R. Kisenge ◽  
...  
Keyword(s):  
Lymphocyte Count ◽  
African Population ◽  
Cd4 Lymphocyte Count ◽  
Hiv Type 1 ◽  
Cd4 Lymphocyte

scholarly journals Isolated renal mucormycosis in a patient with Idiopathic CD4 lymphocytopenia

2018 ◽  
pp. bcr-2018-225234
Author(s):  
Jasmine Sethi ◽  
Raja Ramachandran ◽  
Harbir Singh Kohli ◽  
Krishan Lal Gupta
Keyword(s):  
Case Report ◽  
Combination Therapy ◽  
Autoimmune Hepatitis ◽  
Lymphocyte Count ◽  
Multidisciplinary Approach ◽  
Early Stage ◽  
Fatal Disease ◽  
Cd4 Lymphocyte Count ◽  
Cd4 Lymphocyte ◽  
Idiopathic Cd4 Lymphocytopenia

Idiopathic CD4 lymphocytopenia (ICL) is characterised by a low CD4 +lymphocyte count in the absence of HIV or other underlying aetiologies. We report a case of a 17-year-old girl with ICL with autoimmune hepatitis who developed isolated renal mucormycosis, which, to our knowledge, is the first reported case described in literature. Combination therapy with antifungals and surgical resection was done, and the patient improved. This case report illustrates the importance of timely multidisciplinary approach to recognise this highly fatal disease at an early stage.

scholarly journals Clinical and radiographic features of HIV-related pulmonary tuberculosis according to the level of immunosuppression

2007 ◽  
Vol 40 (6) ◽  
pp. 622-626 ◽  
Author(s):  
Guilherme Freire Garcia ◽  
Alexandre Sampaio Moura ◽  
Cid Sérgio Ferreira ◽  
Manoel Otávio da Costa Rocha
Keyword(s):  
Weight Loss ◽  
Mycobacterium Tuberculosis ◽  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Lymphocyte Count ◽  
Radiographic Features ◽  
Cd4 Lymphocyte Count ◽  
The Mean ◽  
Cd4 Lymphocyte ◽  
Primary Pattern

Medical charts and radiographs from 38 HIV-infected patients with positive cultures for Mycobacterium tuberculosis from sputum or bronchoalveolar lavage were reviewed in order to compare the clinical, radiographic, and sputum bacilloscopy characteristics of HIV-infected patients with pulmonary tuberculosis according to CD4+ lymphocyte count (CD4). The mean age of the patients was 32 years and 76% were male. The median CD4 was 106 cells/mm³ and 71% had CD4 < 200 cells/mm³. Sputum bacilloscopy was positive in 45% of the patients. Patients with CD4 < 200 cells/mm³ showed significantly less post-primary pattern (7% vs. 63%; p = 0.02) and more frequently reported weight loss (p = 0.04). Although not statistically significant, patients with lower CD4 showed lower positivity of sputum bacilloscopy (37% vs. 64%; p = 0.18). HIV-infected patients with culture-confirmed pulmonary tuberculosis had a high proportion of non-post-primary pattern in thoracic radiographs. Patients with CD4 lower than 200 cells/mm³ showed post-primary patterns less frequently and reported weight loss more frequently.

Didanosine Therapy in Patients Intolerant of or Failing Zidovudine Therapy

1992 ◽  
Vol 26 (11) ◽  
pp. 1347-1351 ◽  
Author(s):  
R. Chris Rathbun ◽  
Emory S. Martin
Keyword(s):  
Uric Acid ◽  
Peripheral Neuropathy ◽  
Serum Amylase ◽  
Cd4 Counts ◽  
Expanded Access Program ◽  
Cd4 Lymphocyte Count ◽  
P24 Antigen ◽  
Cd4 Lymphocyte ◽  
Cd4 Cell ◽  
Access Program

OBJECTIVE: To examine the effect of didanosine (2′,3′-dideoxyinosine, ddI) on surrogate markers of HIV infection (CD4+ lymphocyte count, p24 antigen) and to evaluate the incidence of adverse effects from ddI. DESIGN: This study was performed as a retrospective chart review of patients who were enrolled in Bristol-Myers Squibb's expanded-access program for ddI. SETTING: Patient records were obtained from primary care physicians' offices. PATIENTS: Twenty-five HIV-infected patients diagnosed with AIDS or AIDS-related complex (ARC) who were intolerant of zidovudine (ZDV) therapy or deteriorating clinically despite ZDV therapy and were eligible for inclusion in the ddI expanded-access program. INTERVENTION: ddI was administered orally in a citrate-phosphate buffer every 12 hours. Patients were followed by their private physician on a monthly basis. MAIN OUTCOME MEASURES: Laboratory analysis at each month included CD4+ lymphocyte count, hemoglobin, hematocrit, serum amylase, uric acid, serum triglycerides, and p24 antigen. Mean CD4+ cell count, serum amylase, hemoglobin, and uric acid at each month during ddI therapy were compared with baseline concentrations for nine months. RESULTS: Patients had received prior ZDV therapy for an average of 15.5 months before starting ddI. Mean CD4+ cell counts increased from 53.9/mm3 at baseline to 72.4/mm3 after 4 months of therapy (p=0.04) but returned to concentrations comparable with those at baseline after 5 months. One case of documented pancreatitis, two cases of suspected pancreatitis, and nine cases of peripheral neuropathy occurred during ddI therapy. The estimated mean cumulative dose for the development of neuropathy was 1.16 g/kg, which is lower than previously reported. CONCLUSIONS: Patients who have received prolonged therapy with ZDV or who have low initial CD4+ counts may not have sustained increases in CD4+ counts from ddI therapy. Also, development of peripheral neuropathy may occur at lower cumulative doses in these patient populations.

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