475-M. Initial CD4+ T-Cell Counts in Patients with Newly Diagnosed HIV Infection Indicate that a Substantial Proportion of these Patients Have Advanced Disease Regardless of Gender, Race, or Socio-Economic Status

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Session 67 Poster Session
Disease Progression/Effects of Treatment
Session Time: 4:30-6:30 pm
Room 4E-F

475-M.

Initial CD4+ T-Cell Counts in Patients with Newly Diagnosed HIV Infection Indicate that a Substantial Proportion of these Patients Have Advanced Disease Regardless of Gender, Race, or Socio-Economic Status
M. Dybul*¹, R. Bolan², D. Condoluci³, R. Cox-Iyamu⁴, R. Redfield⁵, C. Hallahan¹, K. Sathasivam⁴, M. Folino³, M. Weisberg², M. Andrews³, B. Hidalgo¹, J. Vasquez¹, and A. S. Fauci¹
¹NIAID, NIH, Bethesda, MD; ²Jeffrey Goodman Special Care Program, Glendale, CA; ³Garden State Infectious Disease Associates, Voorhes, NJ; ⁴Whitman Walker Clin., Washington, DC; and ⁵Inst. of Human Virology, Baltimore, MD

Background: CD4+ T-cell counts are a significant determinant of the stage of disease progression and prognosis in HIV-infected individuals. Thus, a diagnosis of HIV infection at a relatively high CD4+ T-cell count may be important for managing patients with regard to treatment decisions, which may ultimately impact prognosis.
Methods: Initial CD4+ T-cell counts of individuals with newly diagnosed HIV infection in 1999 or 2000 were mined from computer files of 4 clinics in urban settings. The data were further analyzed by gender, race, and socio-economic status.
Results: The demographics of the patients were: 73% male, 27% female, 59% black, 29% white, 12% latino, 74% receiving public assistance for healthcare and 26% with private health insurance. 57% of 2223 individuals with newly diagnosed HIV infection had a CD4+ T-cell count < 350 cells/mm³ and 36% had a CD4+ T-cell count < 200 cells/mm³. There were no clear statistical differences in these parameters by gender, race, or socio-economic status.
Conclusions: A majority of HIV-infected individuals in community settings had relatively advanced HIV disease at the time of diagnosis. Approximately 40% of these individuals were diagnosed simultaneously with HIV infection and AIDS, as determined by CD4+ T-cell count. Enhanced educational efforts regarding the importance of HIV testing for at-risk individuals across gender, race, and socio-economic strata in community settings may be important to identify HIV-individuals earlier in infection. This in turn could influence treatment decisions that could impact on the prognosis of patients who receive antiretroviral therapy.

Š2002 9^th Conference on Retroviruses and Opportunistic Infections