Asunto(s)
Antígenos CD7/metabolismo , Linfocitos T CD4-Positivos/inmunología , Infecciones por VIH/diagnóstico , VIH-1/fisiología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Recuento de Linfocito CD4 , Infecciones por VIH/inmunología , Infecciones por VIH/virología , Heroína , Humanos , Pronóstico , Modelos de Riesgos Proporcionales , ARN Viral/sangreRESUMEN
OBJECTIVE: To identify subsets of CD4 T lymphocytes that can predict the development of AIDS and to assess whether increased levels of these cellular markers could provide additional independent prognostic information to the CD4 T cell count and plasma HIV-1-RNA levels. DESIGN AND METHODS: In a prospective study, a cohort of 85 HIV-positive intravenous drug users [clinical categories of the CDC classification A (n = 48) and B (n = 37)] were followed for a period of 37+/-13 months. Memory and activated CD4 and CD8 T cells were quantitated by three-colour flow cytometry at baseline and expressed as a percentage of total CD4 and CD8 lymphocytes. Clinical evaluations were performed at 6 month intervals. The relationships between these lymphocyte subsets and progression to AIDS were studied using Kaplan-Meier plots and proportional hazards regression models. RESULTS: After adjustment for the level of CD4 T cells and plasma HIV-1-RNA levels, the elevation in the subset CD4+CD38+DR+ was the marker within the functionally distinct subsets of CD4 T lymphocytes with additional prognostic value in bivariate Cox regression models. In multivariate models, increased percentages of CD4+CD38+DR+ T cells provided the strongest independent prognostic information for progression to AIDS (relative hazard, 1.07; P < 0.0001). CONCLUSION: Our results suggest that high levels of CD4+CD38+HLA-DR+ T cells reflect the increasing degree of CD4 T cell activation during the progression of HIV infection, and could be used together with the CD4 T cell and HIV-RNA levels to evaluate more accurately the progressive cellular immune impairment associated with the risk of progression to AIDS.
Asunto(s)
Infecciones por VIH/diagnóstico , Infecciones por VIH/inmunología , Activación de Linfocitos/inmunología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Subgrupos de Linfocitos T/inmunología , Adulto , Recuento de Linfocito CD4 , Estudios de Cohortes , Femenino , Infecciones por VIH/fisiopatología , VIH-1/fisiología , Humanos , Masculino , Pronóstico , Estudios Prospectivos , ARN Viral/sangre , Abuso de Sustancias por Vía Intravenosa/inmunologíaRESUMEN
Strains of Haemophilus vaginalis were isolated from patients with leukorrhea. The characteristics of the microorganism that permit its laboratory diagnosis and results of the antibiotic-sensibility tests are described.