Study of the correlation between the changes in the immunologic markers and the clinical progression of HIV infections in Thai patients

Abstract

Three cellular and three serologic markers were evaluated in 61 Thai HIV-infected patients. These included CD₄⁺ T cells , CD₈⁺ T cells , total T cells, serum β₂-microglobulin level, p24 antigen level and anti-p24. They were evaluated for their correlations with the clinical staging and as predictors for clinical progression. The decreased CD₄⁺ T cells, increased β₂-microglobulin level, decreased anti-p24 titer and increased p24 antigen level correlated well with the stages of HIV infection in Thai patients. The abnormalities were most marked in AIDS, followed successively by ARC and PGL or asymptomatic HIV infection. In our sequential 2 year follow-up , the absolute number and percentage of CD₄⁺ T cells, T cells, the absolute number of CD₈⁺ T cells, the elevated β₂-microglobulin level, p24 antigen level and anti-p24 at entry could be reliably used as prognostic markers for HIV Progression. The combinations of p24 Ag with the measurement of CD₄⁺ T cells substantially increased the prognostic value than either was used alone. Furthermore, the initial values of β₂-microglobulin level and CD₄ / CD₈ ratio of the progressors and non-progressors were significantly different. The other markers would become discriminatory only after 1 or more years of follow-up. The progressors, however, could not be differentiated from the non-progressors based on age, sex or risk behaviors. The annual rate of clinical progression in Thai patients from our study was approximately 6.8%. The results obtained in our study of the natural of HIV in Thai patients are essential baseline data for future therapeutic interventions or health policy planning of the country.