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Author Notes:

We thank the investigators, the study staff, and the families who participated in the P2C2 HIV Study and the National Heart, Lung and Blood Institute for the support of the study.

Subjects:

Research Funding:

Supported by National Heart, Lung, and Blood Institute Grants N01-HR-96037, N01-HR-96038, N01-HR-96039, N01-HR-96040, N01-HR-96041, N01-HR-96042, and N01-HR-960043 and in part by National Institutes of Health General Clinical Research Center Grants RR-00071, RR-00188, RR-00533, RR-00643, RR-00645, RR-00865, and RR-02172.

Keywords:

  • Pediatric HIV-1 infection
  • survival
  • CD4+ T cells
  • CD8+ T cells
  • CD19+/20+ B cells
  • serum Igs

Prospective 5-year study of peripheral blood CD4+, CD8+, and CD19+/CD20+ lymphocytes and serum Igs in children born to HIV-1+ women

Tools:

Journal Title:

Journal of Allergy and Clinical Immunology

Volume:

Volume 106, Number 3

Publisher:

, Pages 559-566

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Background Peripheral blood CD4+ and CD8+ T cells, CD19+/20+ B cells, and serum Igs are known to be altered by the progression of pediatric HIV-1 infection, but their evaluation as predictors of survival needs further definition. Objective To determine the natural history of these immune factors and their importance in predicting survival, we studied 298 HIV-1 vertically infected (HIV-1+) children over a 5-year period. Methods These immune factors and serum HIV-1 RNA levels were measured in two groups: (1) a birth cohort of children enrolled up to age 28 days postnatally, including 93 HIV-1+ and 463 HIV-1 uninfected infants (HIV-1−), and (2) an older cohort of 205 HIV-1+ children enrolled after the age of 28 days, who were classified as survivors or nonsurvivors. Results In the birth cohort HIV-1+ children had significantly lower CD4+ T-cell counts, higher CD8+ T-cell counts, and lower CD19+/20+ B-cell counts and higher IgG, IgA, and IgM levels than HIV-1− children. In the older cohort survivors had significantly higher CD4+ and CD8+ T-cell and CD19+/CD20+ B-cell counts and higher IgG, lower IgA, and lower IgM levels than did nonsurvivors. In univariable analysis factors affecting survival in the older cohort were baseline CD4+ and CD8+ T-cell and CD19+/20+ B-cell counts and IgG and HIV-1 RNA levels (all P < .05). In multivariable analysis high baseline CD4+ T-cell count and low baseline HIV-1 RNA load remained important. Conclusion The longitudinal mean profiles of CD4 and CD8 T-cell and CD19/20 B-cell counts and serum IgG levels helped to describe the natural progression of HIV-1 disease in children. However, only baseline CD4 T-cell count independently predicted survival.predicted survival.

Copyright information:

© 2000 Mosby, Inc. All rights reserved.

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