Decline of CD4 Lymphocyte Counts From the Time of Seroconversion in HIV-Positive Women

Abstract

Human immunodeficiency virus (HIV) infection in women is increasing rapidly in North America and worldwide. The decline of CD4 lymphocyte counts from the time of seroconversion has been extensively studied in men, but not in women. We identified retrospectively forty HIV-positive women for whom the date of seroconversion could be determined to within a period of 9 months or less. A mean of 9.4 CD4 lymphocyte measurements per person were available over a mean follow-up period of 1.9 years with a variance of 1.5 years. By simple linear regression analysis, the mean decrease of the population of CD4 lymphocyte count per year was 70 cells/mm³. The mean time at which CD4 lymphocyte counts dropped below 500 was 5.1 years and the time at which CD4 counts dropped below 200 was 9.6 years after seroconversion. A local regression summary (lowess) yielded corresponding mean times of 4.0 years and 9.2 years, respectively. All women had access to continuing medical care, antiretro viral therapy, and had comprehensive social support services available to them. The current data are encouraging in that they indicate that the rate of decline of CD4 count from time of seroconversion in HIV-positive women is no greater than that which occurs in men, and indeed may be less rapid.