Prognostic value of plasma markers of immune activation in patients with advanced HIV disease treated by combination antiretroviral therapy

We assessed the prognostic role of plasma levels of beta (2)-microglobulin, TNF-alpha, sTNFR-II, and IFN-gamma on the progression to AIDS in patients mostly treated with combination antiretroviral therapies. HTV-1-infected pa tients with advanced HN disease (baseline CD4(+) cell count between 50 and 250 x 10(6)/L) were included in a prospective cohort followed up for 36 mon ths. In the 113 patients included, 22 first AIDS-defining events were repor ted. Cumulative probability of AIDS was 12% at M12, 18% at M24, and 20% at M36. Using a Cox model, the baseline level of sTNFR-II (hazard ratio of 3.7 5 for sTNFR-II greater than or equal to 10 ng/ml vs < 10 ng/ml, P = 0.01) w as associated with progression to AIDS. sTNFR-II remained a prognostic fact or before and after the introduction of combinations of antiretrovirals, Wh ether or not this marker is of value in patients exclusively treated with h ighly active antiretroviral therapy needs to be assessed in specific studie s. (C) 2001 Academic Press.