Beta 2-microglobulin as a predictor of death in HIV-infected women from Kigali, Rwanda.
AIDS
; 8(7): 963-9, 1994 Jul.
Article
em En
| MEDLINE
| ID: mdl-7946107
ABSTRACT
OBJECTIVE:
To determine if beta 2-microglobulin (beta 2M) predicts death among HIV-infected African women.DESIGN:
Nested case-control study.SETTING:
Kigali, Rwanda.PARTICIPANTS:
Two hundred and five seroprevalent women known to be HIV-infected since 1986-1987; 67 of whom died of HIV disease (cases) and 138 were alive (controls) as of November 1991. In addition, 128 women who seroconverted between 1986 and 1991. MAIN OUTCOMEMEASURES:
HIV serology, clinical signs and symptoms of HIV disease, hematology variables, and beta 2M concentration.RESULTS:
beta 2M concentration increased over time (P < 0.001) in the seroprevalent women and seroconvertors. The average rate of beta 2M increase in women who died was 0.5 compared with 0.3 mg/l/year in the vital, seroprevalent women (P = 0.07). The strongest independent predictors of death were the rate of change of beta 2M (mg/l/year) [odds ratio (OR), 3.4; 95% confidence interval (CI), 1.7-6.8] and baseline beta 2M concentration (mg/l) [OR, 1.6; 95% CI, 1.2-2.1]. The rate of death for women with beta 2M concentration > or = 7.0 mg/l and a rate of change of beta 2M > or = 0.4 mg/l/year was 7.3 times higher than for women with beta 2M concentration < 7.0 mg/l and a rate of change of beta 2M of < 0.4 mg/l/year (95% CI, 3.1-17.2). The estimated median time from seroconversion to death assuming a constant rate of change of beta 2M was 10.6 years (95% CI, 9.9-11.2) for this cohort of HIV-infected women.CONCLUSIONS:
Elevated beta 2M and a high rate of beta 2M increase were strongly associated with mortality among HIV-infected African women. Based on survival estimates using the rate of change of beta 2M, HIV-infected African women have similar survival compared with HIV-infected adults in the United States.
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Base de dados:
MEDLINE
Assunto principal:
Infecções por HIV
/
Microglobulina beta-2
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
1994
Tipo de documento:
Article