SERUM BETA(2)-MICROGLOBULIN AT HIV-1 SEROCONVERSION AS A PREDICTOR OFSEVERE IMMUNODEFICIENCY DURING 10 YEARS OF FOLLOW-UP

In order to examine the relevance of early immune activation to the lo ng-term course of HIV infection, we evaluated the ability of the serum beta(2)-microglobulin level measured in 63 haemophiliacs on average 4 .9 months from HIV seroconversion to predict the rate of development o f severe immunodeficiency (CD4 lymphocyte count <50/mm(3)) or AIDS ove r the following 10 years. Patients with higher beta(2)-microglobuiin v alues tended to develop severe immunodeficiency/AIDS more rapidly than those with lower levels (relative risk 1.68 per 1 mg/L increase; 95% CI 1.26-2.26; p = 0.0004). Older patients also progressed more rapidly , and these two factors acted independently (relative risk 1.65 per 1 mg/L increase; 95% CI 1.21-2.72; p = 0.002 for beta(2)-microglobulin a nd 1.22 per 10 years; 95% CI 1.01-1.48; p = 0.04 for age). These resul ts provide further evidence that the long-term course of HIV infection can, to some extent, be predicted soon after infection. Older patient s with high Pz-microglobulin levels warrant close monitoring and consi deration for early antiretroviral therapy.