ANALYSIS OF CLINICAL AIDS-FREE INTERVAL AFTER CD4-1 IN JAPANESE HEMOPHILIACS INFECTED WITH HIV-1( CELL COUNTS FALL BELOW 200 X 10(6) L)

We analysed the time from the date CD4+ cell counts fell below 200 x 1 0(6) L-1, defined as t(i), to the onset of clinical AIDS, according to the 1987 Centers for Disease Control and Prevention case definition, in 129 Japanese haemophilia patients infected with HIV-1. The cumulati ve onset of clinical AIDS was analysed by the Kaplan-Meier method and proportional hazard model. Incorporated covariates were age of each pa tient at time t(i), as well as CD4+ and CD8+ cell counts, serum levels of IgG, IgA, IgM, GOT and GPT at t(i). The time of antiretroviral tre atment initiation was also considered. The 50% AIDS-free interval afte r t(i) was 3.00 years (95% confidence interval (CI), range 0.49-5.51) and 1.71 years (95% CI, range 0.66-2.76) for the patients at CDC stage II and stage III, respectively (significantly different, P = 0.0013). Among the patients at CDC stage II at t(i), higher levels of IgA were tightly associated with a shorter period from ti to onset of clinical AIDS (P < 0.0001), and relative hazard was 1.35 (95% CI, 1.11-1.64) w ith increase of IgA level by 1.0 g L-1. Thus there is a broad distribu tion in the time to onset of clinical AIDS in Japanese haemophiliacs e ven after CD4+ cell counts fall below 200 x 10(6) L-1. This should be taken into consideration in deciding upon the therapy and care of HIV- 1 infected people.