title: Clinical staging of HIV infection as a surrogate for CD4 count in HIV-infected children.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) infection is a major cause of infant and childhood mortality and morbidity; without treatment about 50% of them will succumb to HIV/AIDS before the age of two years.
  
  
  OBJECTIVE
  to evaluate the usefulness of clinical manifestations of HIV infection as a surrogate for CD4 counts in antiretroviral-naive HIV-infected children.
  
  
  METHODS
  newly diagnosed HIV-infected children, antiretroviral-naive attending a paediatric infectious diseases unit were enrolled. The clinical manifesta-tions, age, sex, and WHO clinical stage of each patient were determined. CD4 count and CD4% were estimated at presentation and correlated with various clinical manifestations of HIV disease.
  
  
  RESULTS
  the study population consisted of 126 children, aged four months to 14 years with a mean of 3.2 ± 2.7 years and a male to female ratio of 1.2:1. Eighty-one percent of the children acquired HIV infection through mother-to-child transmission (MTCT). The CD4% was higher in infants (p < 0.000) and lower in children over five years of age. Eighty-six percent of them in stage 4 were children less than 24 months of age. CD4% showed a modest correlation with WHO paediatric clinical staging (r=0.62, p=0.002). Patients with lymphadenopathy (stage 1) had a high absolute CD4 count whereas patients with failure to thrive had a relatively low absolute CD4 count.
  
  
  CONCLUSIONS
  WHO Paediatric clinical staging for HIV infection correlates with CD4% and can be used as a surrogate to CD4. CD4 count and CD4% vary with age and complications of the disease.
authors.affiliation: Department of Paediatrics, University of Maiduguri Teaching Hospital, P M B 1414, Maiduguri, Nigeria. ashirugarba@yahoo.com
authors.forename: G M
authors.initials: GM
authors.lastname: Ashir
authors.forename: A I
authors.initials: AI
authors.lastname: Rabasa
authors.forename: M M
authors.initials: MM
authors.lastname: Gofama
authors.forename: H A
authors.initials: HA
authors.lastname: Elechi
authors.forename: B M
authors.initials: BM
authors.lastname: Lawan
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005183:Failure to Thrive / Q000150:complications; D005260:Female; D015658:HIV Infections / Q000145:classification / Q000150:complications / Q000276:immunology* / Q000635:transmission; D015497:HIV-1; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D017678:Sex Distribution; D019562:Viral Load
chemical_list: D015415:Biomarkers