Evaluation of human immunodeficiency virus (HIV) type 1 load, CD4 T cell level, and clinical class as time-fixed and time-varying markers of disease progression in HIV-1-infected children.
Human immunodeficiency virus (HIV) type 1 RNA load, CD4 T cell level, and Centers for Disease Control and Prevention (CDC) clinical class history were measured as potential correlates of a CDC class C diagnosis or death in 165 HIV-1-infected children followed from birth. These covariates were assessed at fixed "landmark" ages from 6 to 24 months and were also assessed as time-varying values. Virus load was associated with progression in all analyses, even after adjusting for immunologic and clinical status. This confirms its importance for monitoring pediatric disease progression. CD4 T cell level was associated with disease progression in time-varying but not in adjusted landmark analysis, suggesting that CD4 cells reflects immediate risk more than long-term risk. The distinction between clinical class B and lower classes is prognostic during the first 18 months of life; class C versus classes N/A/B becomes more important as the patient ages. Virologic, immunologic, and clinical status all provide information regarding disease progression risk.
Kalish
L A
LA
New England Research Institutes, Watertown, MA 02472, USA. lesk@neri. org
McIntosh
K
K
Read
J S
JS
Diaz
C
C
Landesman
S H
SH
Pitt
J
J
Rich
K C
KC
Shearer
W T
WT
Davenny
K
K
Lew
J F
JF
D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D002487:Centers for Disease Control and Prevention, U.S.; D002675:Child, Preschool; D018450:Disease Progression; D015658:HIV Infections / Q000145:classification / Q000276:immunology / Q000503:physiopathology* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D006801:Humans; D007223:Infant; D012367:RNA, Viral / Q000097:blood; D014481:United States; D019562:Viral Load
D015415:Biomarkers; D012367:RNA, Viral