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Prognostically significant classification of immune changes in AIDS with
Kaposi's sarcoma
J Taylor, R Afrasiabi, JL Fahey, E Korns, M Weaver and R Mitsuysau
Sixteen immunological parameters were assessed quantitatively for their
value in providing an immunologically-based and prognostically significant
classification of the immune alteration in 97 patients with AIDS and
Kaposi's sarcoma (AIDS-KS). The dimensions of reductions in the T4 (T
helper-inducer cells) subpopulation of lymphoid cells in the T4-T8 ratio
were found to correlate most closely with prognosis. Most other
immunological changes did not relate to clinical course. T4 lymphocyte
levels greater than 300/microL and a T4-T8 ratio greater than 0.5 indicated
a relatively good prognosis, eg, 85% to 95% survival at 12 months. T4
levels less than 100/microL and/or a T4-T8 ratio less than 0.2 had a very
poor prognosis, eg, less than 25% survival at 12 months. Intermediate T4
levels and T4-T8 ratios had intermediate prognosis. These immunological
findings were found to have independent prognostic value for survival when
compared with disease classifications based on tumor stage (I through IV)
or on clinical status A (without) or B (with fever, night sweats, or weight
loss). Reduced proliferative capacity, increased OKT10 antigen expression,
elevated levels of serum IgA, and immune complexes also correlated with
prognosis. Elevated levels of serum IgG, cellular HLA-DR expression, and
skin test anergy occurred frequently in AIDS-KS but did not have prognostic
significance. Variations in level of total lymphocyte, T8 (T
suppressor/cytotoxic) cell, gamma FcR receptor-positive cell number, NK
activity, or level of serum IgM were less common in AIDS-KS and did not
correlate with prognosis.
Volume 67,
Issue 3,
pp. 666-671,
03/01/1986
Copyright © 1986 by The American Society of Hematology
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