title: Natural history of human immunodeficiency virus type 1 infection in children: prognostic value of laboratory tests on the bimodal progression of the disease.
abstract: This study analyzes the correlation of basic laboratory test results with clinical outcome in 94 children with perinatally acquired human immunodeficiency virus 1 infection who did not receive zidovudine during the study period of 1983 to 1988. Two life-threatening conditions highly correlated with survival, opportunistic infection and severe encephalopathy, were the end points of the study. At a median age of 25 months 30 (32%) of the 94 children had developed such conditions (Group I), and their survival at 3 years of age was 48% (95% confidence interval, 24 to 72%), contrasting with the 97% survival rate (95% confidence interval, 94 to 100%) of the remaining 64 (68%) children who had not developed such conditions by age 25 months. (Group II). Compared with children in Group II, children with life-threatening complications were more likely at the onset of symptoms to be younger and have a lower CD4 count, an impaired in vitro lymphocytic proliferation and a lack of p18 or p25 antibodies in the Western blot profile and, during the progression of the disease, a negative slope of the subsequent CD4 counts. These results highlight the need for an early diagnosis of the human immunodeficiency virus 1 infection in children and demonstrate that it is possible to determine the prognosis of their disease as early as in the first year of life.
authors.affiliation: INSERM Unit 292 (Epidemiology), Bicêtre Hospital, Paris, France.
authors.forename: A M
authors.initials: AM
authors.lastname: Duliege
authors.forename: A
authors.initials: A
authors.lastname: Messiah
authors.forename: S
authors.initials: S
authors.lastname: Blanche
authors.forename: M
authors.initials: M
authors.lastname: Tardieu
authors.forename: C
authors.initials: C
authors.lastname: Griscelli
authors.forename: A
authors.initials: A
authors.lastname: Spira
mesh_terms: D002675:Child, Preschool; D000090266:Chromobox Protein Homolog 5; D005500:Follow-Up Studies; D016655:HIV Core Protein p24; D015658:HIV Infections / Q000276:immunology* / Q000401:mortality* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: C000715594:CBX5 protein, human; D016655:HIV Core Protein p24; D000090266:Chromobox Protein Homolog 5