CD4+ T lymphocytopenia in children: lack of evidence for a new acquired immunodeficiency syndrome agent.
We investigated children with CD4+ T lymphocytopenia to determine the magnitude and public health impact of this condition and to investigate possible causes. Children < 13 years old with CD4+ T lymphocyte counts below age-adjusted cutoffs (age < 24 months, 1000 cells/microliters; age > or = 24 months, 300 cells/microliters) or < 20% on 2 separate measurements were considered to have CD4+ T lymphocytopenia. We solicited information from clinicians and public health departments on these children and their families and collected blood for immunologic and retroviral testing. We identified 18 children (10 boys; 14 African-Americans) with a median age of 10 months at their first low CD4+ T lymphocyte measurement. Three children had had opportunistic infections and two still had low CD4+ T lymphocyte counts 5 and 7 years later. Of the 11 children born to human immunodeficiency virus (HIV)-infected mothers 7 were asymptomatic. Specimens from all children were negative for HIV and human T lymphotropic virus antibodies and negative for HIV by culture or polymerase chain reaction. Among 12 families interviewed no other HIV-seronegative family or household member had illnesses suggestive of immunosuppression. We conclude that negative retroviral tests and lack of illness among their family members do not support the hypothesis that a retrovirus causes CD4+ T lymphocytopenia among these children.(ABSTRACT TRUNCATED AT 250 WORDS)
Lobato
M N
MN
Division of HIV/AIDS, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Public Health States Department of Health and Human Services, Atlanta, GA 30333, USA.
Spira
T J
TJ
Rogers
M F
MF
D000907:Antibodies, Bacterial / Q000032:analysis; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000276:immunology / Q000635:transmission; D018023:HIV Seronegativity / Q000276:immunology*; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D009894:Opportunistic Infections / Q000175:diagnosis / Q000276:immunology; D012192:Retroviridae Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology; D012698:Serologic Tests; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000276:immunology
D000907:Antibodies, Bacterial