THE RELATIONSHIP BETWEEN BETA-2-MICROGLOBULIN, CD4 LYMPHOCYTE COUNT, AIDS AND DEATH IN HIV-POSITIVE INDIVIDUALS

The relationship, in 539 individuals infected with the human immunodef iciency virus (HIV), between two prognostic markers, the CD4 count and beta-2-microglobulin (B2M), and the development of the acquired immun odeficiency syndrome (AIDS) and death was investigated. Cox proportion al hazards models were used to determine the risk of AIDS or death. In a multivariate model which adjusted for demographic factors and treat ment, the most recent measurements of B2M (relative hazard (RH) 1.37 p er g/l higher) and CD4 count (RH 2.17 per log-unit lower) were both si gnificantly associated with the development of AIDS. Similarly, in a m ultivariate model which additionally adjusted for the development of A IDS as a time dependant covariate, there was a strong relationship wit h risk of death for the most recent measurements of B2M (RH 1.34 per g /l higher), and CD4 lymphocyte count (RH 1.91 per log-unit lower). A d ifference in the level of B2M could be used among patients with simila r CD4 counts as an indicator of increased risk of progression to AIDS or death. Using the most recent values of these markers provides a bet ter estimate of the risk of AIDS or death, compared to the more common method of analysis, where baseline values of the markers are used.