[Human immunodeficiency virus infection in children. Clinical and immunological markers of disease progression].
OBJECTIVE
The aim of this study was to analyze the prognostic value of the clinical manifestations and of the lymphocyte CD4 count in a cohort of HIV infected children.


METHODS
We performed a prospective study in 37 HIV infected children during a 6 year period. We studied the statistical association between mortality and clinical and immunological parameters according to Fisher's test (p < 0.05). We performed a survival analysis according to Kaplan-Meier curves (p < 0.05).


RESULTS
We have found that a high risk of mortality is associated with recurrent and severe bacterial infections (p = 0.0001), failure to thrive (p = 0.0057), opportunistic infections (p = 0.0008) and AIDS (p < 0.0001). The survival analysis has shown a low probability of survival in HIV-encephalopathy (p = 0.000053) and high in one case of lymphocytic interstitial pneumonia (p = 0.07). An age-related CD4 count less than 2 SD was associated significantly with a bad prognosis (p = 0 .0017).


CONCLUSIONS
The clinical manifestations and age-matched CD4 count continue being good surrogate markers for the indication of prophylaxis, antiretroviral treatment and as prognostic values of the disease in HIV infected children until new techniques, especially plasma viremia, can be widely available.
Mellado Peña
M J
MJ
Instituto de Salud Carlos III, Madrid.
Cilleruelo Ortega
M J
MJ
Villota Arrieta
J
J
García López
M
M
Pérez Jurado
M L
ML
Barreiro Casal
G
G
Veiga de Cabo
J
J
Martín Fontelos
P
P
D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality; D000293:Adolescent; D017677:Age Distribution; D015704:CD4 Antigens / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006679:HIV Seropositivity / Q000097:blood* / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate
D015704:CD4 Antigens
Infección por el virus de la inmunodeficiencia humana en niños. Marcadores clínicos e inmunológicos de progresión de la enfermedad.