Proposed CD4+T-Cell Criteria for Staging Human Immunodeficiency Virus-Infected Chinese Adults

Abstract

The present treatment, prophylaxis, and prognostic staging of human immunodeficiency virus (HIV) disease rely heavily on peripheral CD4⁺T lymphocyte (CD4) changes. We correlated the clinical course of events and CD4 changes among consecutive HIV-infected ethnic Chinese adults in Hong Kong. Using death as end point, the estimated proportion survival and death incidences were used to compare CDC and proposed staging criteria based on stratified baseline CD4. A separate set of baseline CD4 per microliter (/μl) (percentage lymphocytes) stratification criteria of 1, >220/μl (>12%); 2, 100–220/μl (6–12%); and 3, <100/μl, (<6%) is proposed which can be used for staging HIV-infected Chinese adults. For our study population, our proposed criteria for stratifying baseline CD4 gave better discrimination and more predictive power than the CDC criteria. We assessed the potential impact of these new proposed criteria on anti-retroviral treatment and prophylaxis against opportunistic infections in our adult HIV-infected population.