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What about CD 38
Oct 21, 2001

Dear Doc

Hi. I am wondering why we never hear about including CD38 analysis as part of routine bloodwork ? According to the comments in the article below it has proven to be an invaluable tool in assisting doctors to predict risk of progression, and would also explain why not all CD4 counts or viral loads are equal !

I look forward to your response

xxx According to Giorgi's work, HIV-negative healthy individual's normally have CD38 expression of lower than 1200. CD38 expression on CD8+ cells was looked at according to CD4+ strata in HIV-positive men, and high levels of expression appears to be indicative of disease progression within a three year period. High CD38 expression for people with greater than 500 CD4+ cell counts is 3,000. High CD38 expression for people with CD4+ cell counts between 200 and 500 is 5350. High CD38 expression for people with 200 CD4+ cell counts of less than 200 is 17500. According to Giorgi's work, among people with greater than 500 CD4+ cell count, 40 of those who have CD38 expression greater than 3000 progressed to AIDS within three years, while only 5 of those whose CD38 expression is less than 3000 progressed. In the group of people with CD4+ cell counts ranging from 200 to 500, when CD38 expression is high (i.e. greater than 5350), 55 of people progressed to AIDS within three years whereas only 15 of the low CD38 expressors progressed in the same time frame. In people with CD4+ cell counts less than 200, 78 of those with low CD38 expression progressed to AIDS within three years, but 100 of people with high CD38 expression progressed to AIDS within only one and a half years. Especially for people with high CD4+ counts, CD38 expression on CD8+ cells helped to distinguish progressors from non-progressors.

Response from Dr. Holodniy

I believe more work needs to be done to confirm these observations. This marker may be useful prognostically, but how does that translate to daily practice. In addition, how does HIV treatment impact these results.



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