Prognostic factors in human immunodeficiency virus-positive patients with a cd4 lymphocyte count <50/µl

This analysis investigated variability of survival time in a cohort of 553 human immunodeficiency virus type 1 (HIV-1)-infected homosexual or bisexual men with <50 CD4⁺ cells/µL Median survival after the first CD4⁺ cell count <50/µL was 1.34 years; 25% survived 2 years. Multivariate analysis showed longer survival with concurrent acyclovir and zidovudine use, hemoglobin 12 g/dL, and full-time employment (P <.0001). Other significant covariates associated with longer survival included African-American race, no prior AIDS illness, weight loss <4.5 kg, and zidovudine use (with or without concurrent acyclovir) after CD4⁺ cells fell to <50/µL. An easily derived score identified Multicenter AIDS Cohort Study subjects likely to survive >2 years after CD4+ cell count was <50/µL. Survival once CD4⁺ cell count fell below 50/µL may be longer for persons with a good performance status and specific clinical markers. Health care providers should consider these variables in decision-making strategies and design of clinical trials.