CD4(-LYMPHOCYTE COUNTS AND PATTERNS OF MORTALITY AMONG PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS WHO WERE ENROLLED IN COMMUNITY PROGRAMS FOR CLINICAL RESEARCH ON AIDS() T)

CD4(+) T lymphocyte measurements are used frequently in clinical pract ice and have important prognostic implications. In this study, we desc ribe mortality patterns for 5,204 human immunodeficiency virus (HIV)-i nfected patients classified in different CD4(+) cell strata; patients with and patients without a history of disease progression were includ ed, Patients were enrolled in studies sponsored by the Terry Beirn Com munity Programs for Clinical Research on AIDS of the National Institut e of Allergy and Infectious Diseases between September 1990 and Decemb er 1993. Over a median follow-up period of 23.6 months, 1,703 of the 5 ,204 patients died, For those with CD4(+) cell counts (/mm(3)) of <25, 25-49, 50-99, 100-199, and 200-499, the cumulative mortality rates af ter 24 months were 72%, 58%, 47%, 27%, and 10%, respectively. The medi an survival time was 15 months for those with CD4(+) cell counts of <2 5 cells/mm(3); 21 months for those with CD4(+) cell counts of 25-49 ce lls/mm(3); and 40 months for patients with CD4(+) cell counts of 100-1 99/mm(3), In each CD4(+) cell stratum, mortality rates were higher for those with a history of disease progression at entry into the study; across all CD4(+) cell strata, mortality was 60% greater (relative ris k = 1.6; 95% confidence interval = 1.5-1.8). These data should be usef ul in planning clinical trials, and they have implications in terms of the frequency with which CD4(+) cell counts should be measured to mon itor the progression of HIV infection.