J Med Assoc Thai 2004; 87 (8):951

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Mortality Analysis of HIV-1 Infected Patients for Prioritizing Antiretroviral Drug Therapy
Pathipvanich P Mail, Rojanawiwat A , Ariyoshi K , Miura T , Pumpradit W , Wongchoosie S , Yingseree P , Warachit P , Sawanpanyalert P

Mortality data of patients, classified according to their clinical status and CD4+ cell count status, would be very useful to guide clinicians to prioritizing patients who need antiretroviral drug therapy. In the current study, the authors re-analyzed data derived from a previously published retrospective study of HIV-1-infected individuals at Lampang Hospital in northern Thailand (1) . According to the Cox proportional hazard model, compared to asymptomatic patients with a high CD4+ cell count (> 200 cell/μl), the mortality rate of asymptomatic patients with a medium CD4+ cell count (100-199 cell/μl) did not significantly differ.
However, the mortality rate of patients with a CD4+ cell count below 100 cell/μl was at least 16 times higher, regardless of the presence of clinical symptoms. Based on these results, the authors produced a Lampang
Hospital guideline of antiretroviral drug use; priority of antiretroviral therapy should, therefore, be given to patients with CD4+ cell count < 100 cell/μl.


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