Mortality Analysis of HIV-1 Infected Patients for Prioritizing Antiretroviral Drug Therapy
Panita Pathipvanich MD*, Archawin Rojanawiwat MD**, Koya Ariyoshi MD***,****, Toshiyuki Miura MD***,*****, Wadchara Pumpradit MD***, Suchint Wongchoosie MD*, Pipat Yingseree MD******, Paijit Warachit MD**, Pathom Sawanpanyalert MD**
Affiliation : * Lampang Hospital ** National Institute of Health, DMSc, MOPH *** JICA-NIH Project, DMSc, MOPH **** AIDS Research Center, National Institute of Infectious Diseases, Japan ***** Institute of Medical Science, University of Tokyo, Japan ****** Lampang Provincial Health Office
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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