Abstract
OBJECTIVES. CD4 lymphocyte counts decrease with the duration of human immunodeficiency virus (HIV) infection. We used CD4 counts collected for clinical reasons to evaluate the stage of HIV infection and the epidemiology of recent HIV infections among attendees of South Carolina's public health clinics. METHODS. We measured the CD4 T-lymphocyte counts of persons newly diagnosed with HIV infection April 1989 through June 1990 at South Carolina public health clinics who returned for follow-up. RESULTS. Of 812 newly diagnosed HIV-infected health department patients, 420 (52%) had their CD4 lymphocyte counts measured. Of these 420, 51 (12%) had CD4 counts of < 200, the level below which prophylaxis for pneumocystis pneumonia prolongs survival, and 193 (46%) had CD4 counts of < 500, the level below which zidovudine may prolong disease-free survival. The highest CD4 counts (> or = 900), which are associated with more recent HIV infection, were more common in females. CONCLUSIONS. In South Carolina, almost half of newly reported HIV-infected persons who agreed to CD4 testing at the health department might benefit from immediate drug therapy. Within this population, women may be an emerging risk group that requires specifically directed HIV prevention efforts.
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- Aboulker J. P., Swart A. M. Preliminary analysis of the Concorde trial. Concorde Coordinating Committee. Lancet. 1993 Apr 3;341(8849):889–890. doi: 10.1016/0140-6736(93)93096-j. [DOI] [PubMed] [Google Scholar]
- Brundage J. F., McNeil J. G., Miller R. N., Gardner L. I., Jr, Harrison S. M., Hawkes C., Craig D. B., Redfield R., Burke D. S., Hawks C. The current distribution of CD4+ T-lymphocyte counts among adults in the United States with human immunodeficiency virus infections: estimates based on the experience of the U.S. Army. U.S. Army Retrovirus Research Group. J Acquir Immune Defic Syndr. 1990;3(1):92–94. [PubMed] [Google Scholar]
- Centers for Disease Control (CDC) AIDS in women--United States. MMWR Morb Mortal Wkly Rep. 1990 Nov 30;39(47):845–846. [PubMed] [Google Scholar]
- Denny T., Yogev R., Gelman R., Skuza C., Oleske J., Chadwick E., Cheng S. C., Connor E. Lymphocyte subsets in healthy children during the first 5 years of life. JAMA. 1992 Mar 18;267(11):1484–1488. [PubMed] [Google Scholar]
- Eyster M. E., Goedert J. J., Sarngadharan M. G., Weiss S. H., Gallo R. C., Blattner W. A. Development and early natural history of HTLV-III antibodies in persons with hemophilia. JAMA. 1985 Apr 19;253(15):2219–2223. [PubMed] [Google Scholar]
- Goedert J. J., Biggar R. J., Melbye M., Mann D. L., Wilson S., Gail M. H., Grossman R. J., DiGioia R. A., Sanchez W. C., Weiss S. H. Effect of T4 count and cofactors on the incidence of AIDS in homosexual men infected with human immunodeficiency virus. JAMA. 1987 Jan 16;257(3):331–334. [PubMed] [Google Scholar]
- Graham N. M., Zeger S. L., Park L. P., Vermund S. H., Detels R., Rinaldo C. R., Phair J. P. The effects on survival of early treatment of human immunodeficiency virus infection. N Engl J Med. 1992 Apr 16;326(16):1037–1042. doi: 10.1056/NEJM199204163261601. [DOI] [PubMed] [Google Scholar]
- Hutchinson C. M., Wilson C., Reichart C. A., Marsiglia V. C., Zenilman J. M., Hook E. W., 3rd CD4 lymphocyte concentrations in patients with newly identified HIV infection attending STD clinics. Potential impact on publicly funded health care resources. JAMA. 1991 Jul 10;266(2):253–256. [PubMed] [Google Scholar]
- Masur H., Ognibene F. P., Yarchoan R., Shelhamer J. H., Baird B. F., Travis W., Suffredini A. F., Deyton L., Kovacs J. A., Falloon J. CD4 counts as predictors of opportunistic pneumonias in human immunodeficiency virus (HIV) infection. Ann Intern Med. 1989 Aug 1;111(3):223–231. doi: 10.7326/0003-4819-111-3-223. [DOI] [PubMed] [Google Scholar]
- Melbye M., Biggar R. J., Ebbesen P., Neuland C., Goedert J. J., Faber V., Lorenzen I., Skinhøj P., Gallo R. C., Blattner W. A. Long-term seropositivity for human T-lymphotropic virus type III in homosexual men without the acquired immunodeficiency syndrome: development of immunologic and clinical abnormalities. A longitudinal study. Ann Intern Med. 1986 Apr;104(4):496–500. doi: 10.7326/0003-4819-104-4-496. [DOI] [PubMed] [Google Scholar]
- Moss A. R., Bacchetti P., Osmond D., Krampf W., Chaisson R. E., Stites D., Wilber J., Allain J. P., Carlson J. Seropositivity for HIV and the development of AIDS or AIDS related condition: three year follow up of the San Francisco General Hospital cohort. Br Med J (Clin Res Ed) 1988 Mar 12;296(6624):745–750. doi: 10.1136/bmj.296.6624.745. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Phillips A. N., Lee C. A., Elford J., Janossy G., Timms A., Bofill M., Kernoff P. B. Serial CD4 lymphocyte counts and development of AIDS. Lancet. 1991 Feb 16;337(8738):389–392. doi: 10.1016/0140-6736(91)91166-r. [DOI] [PubMed] [Google Scholar]
- Phillips A., Lee C. A., Elford J., Janossy G., Bofill M., Timms A., Kernoff P. B. Prediction of progression to AIDS by analysis of CD4 lymphocyte counts in a haemophilic cohort. AIDS. 1989 Nov;3(11):737–741. doi: 10.1097/00002030-198911000-00008. [DOI] [PubMed] [Google Scholar]
- Polk B. F., Fox R., Brookmeyer R., Kanchanaraksa S., Kaslow R., Visscher B., Rinaldo C., Phair J. Predictors of the acquired immunodeficiency syndrome developing in a cohort of seropositive homosexual men. N Engl J Med. 1987 Jan 8;316(2):61–66. doi: 10.1056/NEJM198701083160201. [DOI] [PubMed] [Google Scholar]
- Schwartz K., Visscher B. R., Detels R., Taylor J., Nishanian P., Fahey J. L. Immunological changes in lymphadenopathy virus positive and negative symptomless male homosexuals: two years of observation. Lancet. 1985 Oct 12;2(8459):831–832. doi: 10.1016/s0140-6736(85)90816-5. [DOI] [PubMed] [Google Scholar]
- St Louis M. E., Conway G. A., Hayman C. R., Miller C., Petersen L. R., Dondero T. J. Human immunodeficiency virus infection in disadvantaged adolescents. Findings from the US Job Corps. JAMA. 1991 Nov 6;266(17):2387–2391. [PubMed] [Google Scholar]
- Volberding P. A., Lagakos S. W., Koch M. A., Pettinelli C., Myers M. W., Booth D. K., Balfour H. H., Jr, Reichman R. C., Bartlett J. A., Hirsch M. S. Zidovudine in asymptomatic human immunodeficiency virus infection. A controlled trial in persons with fewer than 500 CD4-positive cells per cubic millimeter. The AIDS Clinical Trials Group of the National Institute of Allergy and Infectious Diseases. N Engl J Med. 1990 Apr 5;322(14):941–949. doi: 10.1056/NEJM199004053221401. [DOI] [PubMed] [Google Scholar]
- Weber J. N., Wadsworth J., Rogers L. A., Moshtael O., Scott K., McManus T., Berrie E., Jeffries D. J., Harris J. R., Pinching A. J. Three-year prospective study of HTLV-III/LAV infection in homosexual men. Lancet. 1986 May 24;1(8491):1179–1182. doi: 10.1016/s0140-6736(86)91160-8. [DOI] [PubMed] [Google Scholar]
- Yanase Y., Tango T., Okumura K., Tada T., Kawasaki T. Lymphocyte subsets identified by monoclonal antibodies in healthy children. Pediatr Res. 1986 Nov;20(11):1147–1151. doi: 10.1203/00006450-198611000-00017. [DOI] [PubMed] [Google Scholar]
- de Wolf F., Lange J. M., Houweling J. T., Mulder J. W., Beemster J., Schellekens P. T., Coutinho R. A., van der Noordaa J., Goudsmit J. Appearance of predictors of disease progression in relation to the development of AIDS. AIDS. 1989 Sep;3(9):563–569. doi: 10.1097/00002030-198909000-00002. [DOI] [PubMed] [Google Scholar]
- el-Sadr W., Marmor M., Zolla-Pazner S., Stahl R. E., Lyden R., William D., D'Onofrio S., Weiss S. H., Saxinger W. C. Four-year prospective study of homosexual men: correlation of immunologic abnormalities, clinical status, and serology to human immunodeficiency virus. J Infect Dis. 1987 Apr;155(4):789–793. doi: 10.1093/infdis/155.4.789. [DOI] [PubMed] [Google Scholar]