論文ID: JJID.2014.261
Suitable methods for clinical monitoring of HIV-infected patients are very crucial in resource-poor setting areas. Demographic data, clinical staging and laboratory findings for 112 HIV asymptomatic subjects were assessed at the first admission and the last visit from 2002 to 2010. On Cox regression analysis, hemoglobin (Hb) (HR=0.643, p=0.021) was predictive indicator for disease progression, however; in spite of having significant probability values, CD4, CD8 and platelet counts showed low hazard ratios. Hb and total lymphocyte count (TLC) demonstrated a phase of rapid declining rates (10.9 and 29.6%, respectively) from stage II to III. Lower count of CD4, platelet and Hb at the stage-I were associated with disease progression, and TLC was correlated with CD4 count at the last follow-up (p<0.001). However, WHO cutoff point of 1200 cell/mm3 for TLC had 26.1% sensitivity and 98.6% specificity. Using ROC curve, TLC count of 1800 cell/mm3 was more reliable in this region. Statistical analysis and data mining findings showed that Hb, TLC and their rapid decline from stage II to III and lower platelet count could be considered as valuable markers for introducing a surrogate algorithm for monitoring of HIV-infected subjects and starting anti-viral therapy in the absence of sophisticated detection assays.
