Total lymphocyte count: not a surrogate marker for risk of death in HIV-infected Ugandan children.
OBJECTIVE
To determine the utility of total lymphocyte count (TLC) in predicting the 12-month mortality in HIV-infected Ugandan children and to correlate TLC and CD4 cell %.


METHODS
This is a retrospective data analysis of clinical and laboratory data collected prospectively on 128 HIV-infected children in the HIV Network for Prevention Trials 012 trial.


METHODS
TLC and CD4 cell % measurements were obtained at birth, 14 weeks, and 12, 24, 36, 48, and 60 months of age and assessed with respect to risk of death within 12 months.


RESULTS
Median TLC per microliter (CD4 cell %) was 4150 (41%) at birth, 4900 (24%) at 12 months, 4300 (19%) at 24 months, 4150 (19%) at 36 months, 4100 (18%) at 48 months, and 3800 (20%) at 60 months. The highest risk of mortality within 12 months was 34% - 37% at birth and declined to 13%-15% at 24 months regardless of TLC measurement. The correlation between CD4 cell % and TLC was extremely low overall (r = 0.01).


CONCLUSIONS
The TLC did not predict a risk of progression to death within 12 months in HIV-infected Ugandan children. Therefore, TLC alone may not be a useful surrogate marker for determining those children at highest risk of death, who require antiretroviral therapy most urgently.
Musoke
Philippa M
PM
Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda. pmusoke@mujhu.org
Young
Alicia M
AM
Owor
Maxensia A
MA
Lubega
Irene R
IR
Brown
Elizabeth R
ER
Mmiro
Francis A
FA
Mofenson
Lynne M
LM
Jackson
J Brooks
JB
Fowler
Mary Glenn
MG
Guay
Laura A
LA