• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of cdliPermissionsJournals.ASM.orgAEM ArticleJournal InfoAuthorsReviewers
Clin Diagn Lab Immunol. Jul 1997; 4(4): 474–477.
PMCID: PMC170553

Immunological markers of disease progression in patients infected with the human immunodeficiency virus.


Identification of inexpensive and technically simple immunological tests useful in predicting the progression to AIDS in human immunodeficiency virus (HIV)-infected patients would be especially welcome in developing countries, in which 80% of HIV-infected patients reside and health budgets are low. In the current study, we evaluated CD4+ and total lymphocyte counts and the concentrations in serum of beta 2-microglobulin, p24 antigen, and immunoglobulin A (IgA) as predictors of disease progression in 74 Panamanian HIV-positive patients and 50 HIV-negative healthy individuals. Total lymphocyte and CD4(+)-cell counts for AIDS patients (1,451 +/- 811 cells/microliters, P < 0.001, and 238 +/- 392 cells/microliters, P < 0.0001, respectively and asymptomatic patients (2,393 +/- 664 cells/microliters, P > 0.05, and 784 +/- 475 cells/microliters, P < 0.001, respectively) were lower than those observed for healthy subjects (2,596 +/- 631 cells/microliters and 1,120 +/- 296 cells/microliters, respectively). The levels of beta 2-microglobulin and IgA in serum were significantly elevated in patients with AIDS (5.7 +/- 3.6mg/liter, P < 0.001, and 541 +/- 265 mg/dl, P < 0.0002, respectively) and asymptomatic infected subjects (3.4 +/- 2.1 mg/liter, P = 0.001, and 436 +/- 216 mg/dl, P < 0.0001, respectively) compared with the levels in healthy subjects (2.2 +/- 0.7 mg/liter and 204 +/- 113 mg/dl, respectively). Nonstatistically significant differences (P > 0.05) for concentrations of p24 antigen between asymptomatic infected patients (29 +/- 13 pg/ml) and AIDS patients (40 +/- 23 pg/ml) were observed. Total lymphocyte counts of 1,750 cells/microliters or less, CD4 counts of 200 cells/microliters or less, beta 2-microglobulin concentrations in serum of 4 mg/liter or higher, concentrations of IgA in serum of 450 mg/dl or higher, and the presence in serum of p24 antigen were correlated with elevated risks for developing AIDS. Monitoring both total lymphocytes and beta 2-microglobulin identified 91% of the AIDS patients; these assays may allow reductions in the annual number of CD4(+)-cell evaluations and the costs associated with monitoring both total lymphocytes and beta 2-microglobulin identified 91% of the AIDS patients; these assays may allow reductions in the annual number of CD4(+)-cell evaluations and the costs associated with monitoring the immune status of HIV-positive patients.

Full Text

The Full Text of this article is available as a PDF (164K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Anderson RE, Lang W, Shiboski S, Royce R, Jewell N, Winkelstein W., Jr Use of beta 2-microglobulin level and CD4 lymphocyte count to predict development of acquired immunodeficiency syndrome in persons with human immunodeficiency virus infection. Arch Intern Med. 1990 Jan;150(1):73–77. [PubMed]
  • Zangerle R, Wachter H, Fuchs D. Immune activation markers and CD4+ T-cell counts in HIV-infected intravenous drug users. J Acquir Immune Defic Syndr. 1992 Dec;5(12):1273–1274. [PubMed]
  • Clerici M, Shearer GM. The Th1-Th2 hypothesis of HIV infection: new insights. Immunol Today. 1994 Dec;15(12):575–581. [PubMed]
  • Cunningham AL, Dwyer DE, Dowton DN. Viral markers in HIV infection and AIDS. J Acquir Immune Defic Syndr. 1993;6 (Suppl 1):S32–S35. [PubMed]
  • Fahey JL, Taylor JM, Detels R, Hofmann B, Melmed R, Nishanian P, Giorgi JV. The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type 1. N Engl J Med. 1990 Jan 18;322(3):166–172. [PubMed]
  • Fauci AS. The human immunodeficiency virus: infectivity and mechanisms of pathogenesis. Science. 1988 Feb 5;239(4840):617–622. [PubMed]
  • Gafà S, Giudici MG, Pezzotti P, Rezza G. IgA as a marker of clinical progression among HIV-seropositive intravenous drug users. J Infect. 1993 Jan;26(1):33–38. [PubMed]
  • Masur H, Ognibene FP, Yarchoan R, Shelhamer JH, Baird BF, Travis W, Suffredini AF, Deyton L, Kovacs JA, Falloon J, et al. CD4 counts as predictors of opportunistic pneumonias in human immunodeficiency virus (HIV) infection. Ann Intern Med. 1989 Aug 1;111(3):223–231. [PubMed]
  • Matsuda S, Oka S, Honda M, Takebe Y, Takemori T. Characteristics of IgA antibodies against HIV-1 in sera and saliva from HIV-seropositive individuals in different clinical stages. Scand J Immunol. 1993 Nov;38(5):428–434. [PubMed]
  • Iijima T, Witter MP, Ichikawa M, Tominaga T, Kajiwara R, Matsumoto G. Entorhinal-hippocampal interactions revealed by real-time imaging. Science. 1996 May 24;272(5265):1176–1179. [PubMed]
  • Phillips AN, Sabin CA, Elford J, Bofill M, Lee CA, Janossy G. CD8 lymphocyte counts and serum immunoglobulin A levels early in HIV infection as predictors of CD4 lymphocyte depletion during 8 years of follow-up. AIDS. 1993 Jul;7(7):975–980. [PubMed]
  • Ruffault A, Michelet C, Jacquelinet C, Guist'hau O, Genetet N, Bariou C, Colimon R, Cartier F. The prognostic value of plasma viremia in HIV-infected patients under AZT treatment: a two-year follow-up study. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jul 1;9(3):243–248. [PubMed]
  • Schwartländer B, Bek B, Skarabis H, Koch J, Burkowitz J, Koch MA. Improvement of the predictive value of CD4+ lymphocyte count by beta 2-microglobulin, immunoglobulin A and erythrocyte sedimentation rate. The Multicentre Cohort Study Group. AIDS. 1993 Jun;7(6):813–821. [PubMed]
  • Sweet SP, Rahman D, Challacombe SJ. IgA subclasses in HIV disease: dichotomy between raised levels in serum and decreased secretion rates in saliva. Immunology. 1995 Dec;86(4):556–559. [PMC free article] [PubMed]
  • Villa G, Monteleone D, Marra C, Bartoli A, Antinori A, Pallavicini F, Tamburrini E, Izzi I. Neuropsychological abnormalities in AIDS and asymptomatic HIV seropositive patients. J Neurol Neurosurg Psychiatry. 1993 Aug;56(8):878–884. [PMC free article] [PubMed]
  • Zabay JM, Sempere JM, Benito JM, Gonzalez B, Obregón E, Díez J, Fernández-Cruz E. Serum beta 2-microglobulin and prediction of progression to AIDS in HIV-infected injection drug users. J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Mar 1;8(3):266–272. [PubMed]

Articles from Clinical and Diagnostic Laboratory Immunology are provided here courtesy of American Society for Microbiology (ASM)


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles
  • Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...