REPEAT, SH LEVELS ALONE ARE PREDICTORS OF AIDS AND MORTALITY 20 September 2004
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Eleni Papadopulos-Eleopulos,
Biophyscist
Department of Medical Physics, Royal Perth Hospital, Western Australia, 6001,
Valendar F Turner, John Papadimitriou, Barry Page, David Causer, Helman Alfonso, Sam Mhlongo, Todd Miller, Christian Fiala

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Re: REPEAT, SH LEVELS ALONE ARE PREDICTORS OF AIDS AND MORTALITY

REPEAT, SH LEVELS ALONE ARE PREDICTORS OF AIDS AND MORTALITY

In his rapid response: "SH levels alone are NOT prediction of AIDS and mortality", 8 September, Christopher Noble wrote: "I asked "Can you use the glutathione levels ALONE to predict who has a high probability of developing AIDS defining illnesses?"

The Perth Group answered: Yes, you can.

The papers that have been cited do not support this claim."

We have cited 3 papers. Christopher Noble makes comments regarding the evidence in one of them, Herzenberg et al. Would Christopher Noble please tell us why the evidence in the other two papers we have cited does not support our claim.

Regarding the evidence in the Herzenberg et al paper, Christopher Noble wrote: "Glutathione levels IN HIV INFECTED INDIVIDUALS can predict mortality. However, a large percentage of healthy controls also have low glutathione levels. Figure 2: Herzenberg et al. The cut-off determined by Herzenberg et al to separate survival from non-survival falls inside the range of glutathione levels in healthy controls. Glutathione levels together with HIV serostatus can predict mortality. Glutathione levels ALONE cannot."

Because some of the controls (19%) had low levels, does not mean that the SH are not significant predictors. In addition: (a) "The percentage of female subjects was higher (30%) in the control group"; (b) no mention is made in regard to the health status of the controls.

Under the subtitle "GSB [SH] Levels Predict Survival", Herzenberg et al wrote: "Proportional hazard analyses in which GSB levels and CD4 T cell counts are included in the model also demonstrate that GSB levels significantly predict survival (Table 2). Although GSB correlates loosely but significantly with CD4 T cell counts (Pearson's r = 0.33, P < 0.0001), the combined entry of the two parameters in the model confirms the predictive value of GSB independent of its correlation with CD4 T cell count. Thus, by all measures, GSB (in CD4 T cells) emerges as a powerful yardstick for predicting survival in HIV infection".

That is, SH levels are independent (of CD4 counts and thus HIV) predictors of mortality.

Competing interests: None declared