Abstract
CD4 + T-lymphocyte counts are used to assess CD4 + decline and the stage of human immunodeficiency virus (HIV) progression in HIV-infected patients. Clinical observation suggests that HIV progress more rapid in females than males. Of the original 5000 HIV-infected population of Western New York HIV/AIDS, Referral Center at Erie County Medical Center (ECMC), 1422 participated in the cohort study. We identified 333 HIV-infected patients with CD4 + T-cell-counts ≥ 500/µƖ, among them 178 met the inclusion criteria for the 10-year study. Females had higher mode (600 vs. 540) and mean (741.9 vs. 712.2) CD4 + counts than males at baseline. However, CD4 + declined faster among females in a shorter time than males (234.5 vs. 158.6, P < 0.004), with rapid HIV progression. Univariate analyses determined that females had a 40% higher risk for CD4 + decline than males. The bivariate analyses specified CD4 + decline remained greater in females than males. Multivariate analyses which employed Cox’s proportional Hazard-Model to adjust for numerous variables simultaneously identified women had almost twice the risk for CD4 + decline and rapid HIV progression than males (RR = 1.93; 95%CI 1.24, 2.99). Although the biological mechanism remains unknown, findings suggest gender differences in CD4 + decline, with a higher risk of rapid HIV progression and shorter longevity in females.
Highlights
CD4 + T-lymphocyte counts are used to assess CD4 + decline and the stage of human immunodeficiency virus (HIV) progression in HIV-infected patients
HIV is a contagious, deadly disease that has rapidly spread w orldwide[1]. It is a member of the lentivirus group of retroviruses that infects T-lymphocyte white blood cells (WBC) with CD4 + surface r eceptors[2]
This is a longitudinal cohort study conducted on HIV-infected patients that excluded patients with the following criteria: 1) If they were placed on any type of combination antiretroviral medication or protease inhibitors (PI’s) that may interfere with the natural history of progression, 2) CD4 + T-lymphocyte count500/ μƖ, 3) pregnant woman at entry or within the first 6 months of the study, 4) diagnosed with non-HIV-immunosuppression, 5) patients with signs/symptoms of opportunistic infections (OI’s), and 6) who die within the first 6 months of the study
Summary
CD4 + T-lymphocyte counts are used to assess CD4 + decline and the stage of human immunodeficiency virus (HIV) progression in HIV-infected patients. Multivariate analyses which employed Cox’s proportional Hazard-Model to adjust for numerous variables simultaneously identified women had almost twice the risk for CD4 + decline and rapid HIV progression than males (RR = 1.93; 95%CI 1.24, 2.99). The biological mechanism remains unknown, findings suggest gender differences in CD4 + decline, with a higher risk of rapid HIV progression and shorter longevity in females. HIV is a contagious, deadly disease that has rapidly spread w orldwide[1] It is a member of the lentivirus group of retroviruses that infects T-lymphocyte white blood cells (WBC) with CD4 + surface r eceptors[2]. The HIV virus attacks CD4 + T-cells, kills them, decreases immune function, and leads to opportunistic infections (OI’s) and rare cancers It is very rare for OI’s to occur when the CD4 + T-lymphocyte count is ≥ 500μƖ3. Due to socio-demographic and socio-behavioral status, females appeared to be more susceptible to increase risk of CD4 + decline and HIV progression compared with m ales[11]
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