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Analysis of clinical AIDS‐free interval after CD4+ cell counts fall below 200 × 106 L−1 in Japanese Haemophiliacs infected with HIV‐1

We analysed the time from the date CD4+ cell counts fell below 200 × 106 L−1, defined as ti, to the onset of clinical AIDS, according to the 1987 Centers for Disease Control and Prevention case definition, in 129 Japanese Haemophilia patients infected with HIV‐1. The cumulative onset of clinical AIDS was analysed by the Kaplan–Meier method and proportional hazard model. Incorporated covariates were age of each patient at time ti, as well as CD4+ and CD8+ cell counts, serum levels of IgG, IgA, IgM, GOT and GPT at ti. The time of antiretroviral treatment initiation was also considered. The 50% AIDS‐free interval after ti was 3.00 years (95% confidence interval (CI), range 0.49–5.51) and 1.71 years (95% CI, range 0.66–2.76) for the patients at CDC stage II and stage III, respectively (significantly different, P= 0.0013). Among the patients at CDC stage II at ti, higher levels of IgA were tightly associated with a shorter period from ti to onset of clinical AIDS (P < 0.0001), and relative hazard was 1.35 (95% CI, 1.11–1.64) with increase of IgA level by 1.0 g L−1. Thus there is a broad distribution in the time to onset of clinical AIDS in Japanese Haemophiliacs even after CD4+ cell counts fall below 200 × 106 L−1. This should be taken into consideration in deciding upon the therapy and care of HIV‐1 infected people.