Prognostic usefulness of the walter reed staging classification for hiv infection

Keith B. Macdonell*, Joan S. Chmiel, Joanne Goldsmith, Carl Bertil Wallemark, James Steinberg, Elaine Byers, John P. Phair

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


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 asignificant predictor for progression to AIDS, but only in individuals with low CD4 counts.

Original languageEnglish (US)
Pages (from-to)367-374
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number4
StatePublished - Aug 1988


  • CD4 cells
  • Classification system
  • Disease progression
  • HIV infection
  • Lymphadenopathy
  • Skin testing

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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