PubMed · 3235811
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P Ashworth. 1988. Strength in unity--and creativity.. https://doi.org/10.1016/0266-612x(88)90053-3
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Although oral candidiasis lesions are widely recognized as markers for AIDS, the relative prognostic significance of functions of these episodes has not been examined. We compare the associations with time to AIDS of one fixed and six time-dependent metrics of oral candidiasis lesions, including proximity of a lesion to seroconversion, any candidiasis history, and recency of a lesion. We show in Cox regression models that two metrics are clinically and statistically far more significant than the others, alone or in combination: any history of candidiasis since HIV seroconversion, and recency of a candidiasis episode. The latter metric indicates that the risk of an AIDS diagnosis is high during a candidiasis episode. The results hold for two cohorts of male seroconverters, 627 haemophiliacs and 196 men who have sex with men. Identification of highly prognostic functions of a patient's oral candidiasis history allows clinicians and researchers to focus on these aspects of the history and to omit extraneous information from data collection. Our method extends well beyond candidiasis and AIDS, and may shed light on associations of covariates with outcomes in a variety of settings.
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Disturbances in inflammatory cytokine production and immune regulation coupled with human herpesvirus-8 (HHV-8) infection underlie the current understanding of the pathogenesis of Kaposi's sarcoma (KS), the most common HIV-associated malignancy. The low affinity Fc gamma receptors (FcgammaR) for IgG link humoral and cellular immunity by mediating interaction between antibodies and effector cells, such as phagocytes and natural killer cells. We examined the frequency of polymorphic forms of the low affinity FcgammaRs, FcgammaRIIA, FcgammaRIIIA, and FcgammaRIIIB in 2 cohorts of HIV-infected men with KS and found that the FcgammaRIIIA genotype exerts a significant influence on susceptibility to or protection from KS. The FF genotype was underrepresented in patients with KS, whereas the VF genotype was associated with development of KS. A similar association was observed between FcgammaRIIIA genotypes and HHV-8 seropositivity. These observations suggest a possible role for FcgammaRIIIA in the development of KS during HIV infection.