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Prognostic Usefulness of the Walter Reed Staging Classification for HIV Infection

MacDonell Keith B.; Chmiel, Joan S.; Goldsmith, JoAnne; Wallemark, Carl-Bertil; Steinberg, James; Byers, Elaine; Phair, John P.
JAIDS Journal of Acquired Immune Deficiency Syndromes: August 1988
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We evaluated the usefulness of both the Walter Reed (WR) staging classification and the component criteria used in the system in predicting progression to AIDS. The WR classification was applied to a cohort of 431 men who were seropositive for the human immunodeficiency virus on entry into a prospective study. The WR classification was of limited usefulness, as only 133 men (31%) could be assigned to a WR stage. Among men who could be WR classified, only individuals in WR stage 5 were found to have a significantly more rapid progression to AIDS. The seropositive cohort was also classified based on initial CD4 cell number. Low CD4 counts (<400 cells/mm3) were significantly associated with progression to AIDS, and grouping seropositive men by CD4 number alone provided as much prognostic information as the WR classification. Skin test anergy was also a significant predictor for progression to AIDS, but only in individuals with low CD4 counts.

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