AIDS (London, England) · 1993
Evaluation of two staging systems for HIV infection for use in developing countries.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Vandenbruaene M, Colebunders R, Goeman J, Alary M, Farber C M, Kestens L, van Ham G, Van den Ende J, Van Gompel A, Van den Enden E
Аннотация
OBJECTIVE: To evaluate the clinical axis of the World Health Organization (WHO) clinical staging system and the modified WHO staging system proposed by Montaner et al. using the lymphocyte strata > 1500, 1500-1000 and < 1000 cells x 10(6)/l.
DESIGN: Cross-sectional study.
PATIENTS: Four hundred and fifteen consecutive patients with HIV infection attending three HIV reference centres in Belgium.
METHODS: Absolute CD4 lymphocyte counts were compared between stages within the two staging systems.
RESULTS: Median CD4 lymphocyte counts decreased with increasing stage of disease in both staging systems. Differences in median CD4 lymphocyte counts between stages of each staging system were statistically significant (Kruskal-Wallis one-way analysis of variance, P < 0.001). The WHO clinical stage 1 and the modified WHO stage I had positive predictive values of 56 and 58%, respectively, for identifying patients with CD4 lymphocyte levels > 500 cells x 10(6)/l. The WHO clinical stage 4 and the modified WHO stage IV had positive predictive values of 79 and 80%, respectively, for identifying patients with CD4 lymphocyte levels < 200 cells x 10(6)/l.
CONCLUSIONS: The WHO clinical staging system or a modified version of this system using lymphocytes stratification may be a good alternative in developing countries to the CD4 lymphocyte count-based HIV staging system used in the developed world. Cohort studies in developing countries are needed to assess their prognostic value.
DESIGN: Cross-sectional study.
PATIENTS: Four hundred and fifteen consecutive patients with HIV infection attending three HIV reference centres in Belgium.
METHODS: Absolute CD4 lymphocyte counts were compared between stages within the two staging systems.
RESULTS: Median CD4 lymphocyte counts decreased with increasing stage of disease in both staging systems. Differences in median CD4 lymphocyte counts between stages of each staging system were statistically significant (Kruskal-Wallis one-way analysis of variance, P < 0.001). The WHO clinical stage 1 and the modified WHO stage I had positive predictive values of 56 and 58%, respectively, for identifying patients with CD4 lymphocyte levels > 500 cells x 10(6)/l. The WHO clinical stage 4 and the modified WHO stage IV had positive predictive values of 79 and 80%, respectively, for identifying patients with CD4 lymphocyte levels < 200 cells x 10(6)/l.
CONCLUSIONS: The WHO clinical staging system or a modified version of this system using lymphocytes stratification may be a good alternative in developing countries to the CD4 lymphocyte count-based HIV staging system used in the developed world. Cohort studies in developing countries are needed to assess their prognostic value.