[Prognostic markers of progression to AIDS in infants vertically infected by human immunodeficiency virus type-1].
BACKGROUND
To study the prognostic AIDS progression value of the percentage of CD4+, CD8+, and plasma viral load (VL) (copies/ml) in HIV-1-vertically infected children.


METHODS
We study a cohort of 115 HIV-1 infected children older than 12 months of age. The VL was quantified using standard molecular assay. CD4 and CD8 T lymphocytes were determined by flow cytometry.


RESULTS
The children with a median of VL > 4.5 log10 (p < 0.001) and percentage of CD8+ < 25% (p = 0.05) during follow-up, progressed faster to AIDS than children with a median of VL < 4.5 log10 and CD8 > 25%. The relative risk (RR) of AIDS progression was 7-fold higher in children with median VL above 4.5 log10. When considering VL as a continuous variable, risk of progression to AIDS is 3.5-fold higher for each increase of one log10 of VL. The percentage of CD8+ T-cells had a RR of AIDS progression of 0.95/% CD8+ at entry to the study and of 0. 19/% CD8+ during follow-up, indicating protection against progression to AIDS.


CONCLUSIONS
Our results indicate that each basal values at entry in the study and during the follow-up of the percentage of CD8+ and VL helps to determine the risk of AIDS progression in HIV-1-infected children. More interestingly, the use of the two predictive markers together had higher predictive value.
Resino
S
S
Servicio de Inmunología. Hospital General Universitario Gregorio Marañón. Madrid.
Bellón
J M
JM
Gurbindo
D
D
Ramos
J T
JT
Ruiz Contreras
J
J
Muñoz-Fernández
M A
MA
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis* / Q000635:transmission* / Q000821:virology; D000704:Analysis of Variance; D015415:Biomarkers; D018414:CD8-Positive T-Lymphocytes; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005500:Follow-Up Studies; D015497:HIV-1; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012306:Risk; D013997:Time Factors; D019562:Viral Load
D015415:Biomarkers