title: Assessment of the prognostic value of the World Health Organization clinical staging system for HIV/AIDS in HIV-infected children and adolescents in a cohort in Belo Horizonte, Brazil.
abstract: This study aimed to evaluate the prognostic value of WHO clinical staging system in HIV-infected children and adolescents in Belo Horizonte, Brazil. WHO clinical stages were evaluated for risk of disease progression in 335 patients admitted from 1989 to 2003. In Kaplan-Meier analysis, age, clinical stage, CD4% <15% and viral load >5 log(10) were statistically significant. In Cox proportional hazards model, the relative risk of disease progression for Stage 4 at admission and in the worst moment were 3.47 [confidence interval (CI) 95% CI = 1.92-6.26] and 2.89 (95% CI = 1.44-5.79). Stages 2 and 3 were neutral as predictors of risk either of disease progression. CD4% <15% and viral load > 5 log(10) remained statistically significant in multivariate analysis. WHO clinical Stage 4 was a good predictor of risk of progression in this cohort. The findings support WHO proposition to start antiretroviral treatment for patients at a more advanced clinical stage.
authors.affiliation: Pediatric, Adolescent and Maternal HIV/AIDS Group, School of Medicine, Federal University of Minas Gerais, Brazil.
authors.forename: Claudete A Araújo
authors.initials: CA
authors.lastname: Cardoso
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Pinto
authors.forename: Talitah M Sanchez
authors.initials: TM
authors.lastname: Candiani
authors.forename: Inácio R
authors.initials: IR
authors.lastname: Carvalho
authors.forename: André Grossi
authors.initials: AG
authors.lastname: Dantas
authors.forename: Eugênio M Andrade
authors.initials: EM
authors.lastname: Goulart
mesh_terms: D000293:Adolescent; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001938:Brazil; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D019562:Viral Load; D014944:World Health Organization; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents