Document 0731
 DOCN  M9650731
 TI    Immunological characteristics of HIV-infected children: relationship to
       age, CD4 counts, disease progression, and survival.
 DT    9605
 AU    Chirmule N; Lesser M; Gupta A; Ravipati M; Kohn N; Pahwa S; Department
       of Pediatrics, North Shore University Hospital-Cornell; University
       Medical College, Manhasset, New York 11030, USA.
 SO    AIDS Res Hum Retroviruses. 1995 Oct;11(10):1209-19. Unique Identifier :
       AIDSLINE MED/96157209
 AB    We have evaluated immunologic markers of disease progression in 79
       children perinatally infected with HIV. Laboratory testing included T
       lymphocyte subsets and lymphoproliferative responses (LPR) to mitogens
       (PHA, Con A, and PWM), antigens (Candida, Tetanus), and alloantigens
       (MLC). Patients were graded into grades I, II, and III based on results
       of CD4 counts, and into grades A, B, and C based on results of LPR, with
       grades I and grades A being normal, III and C being the lowest, and II
       and B falling in-between. CD4 counts, CD4/CD8 ratio, and
       lymphoproliferative responses were markedly decreased in a majority of
       children. Grade III CD4 counts were almost always associated with
       decreased LPR. A majority of the children with grade I CD4 numbers,
       however, also had abnormal lymphoproliferative responses. Results of
       laboratory testing were analyzed in relation to clinical disease
       progression and survival. The first AIDS defining illnesses (ADI),
       especially opportunistic infections (OI), was usually associated with
       Grade III/C results in immunologic assays. Survival was significantly
       decreased in children with grade III CD4 cell counts, and grade C LPR,
       and was poorest if these abnormalities developed within the first year
       of life. In this latter age group, if the CD4 counts fell to grade III,
       the risk for dying was at least five times greater than those children
       with higher CD4 counts (grades II and I); if the proliferative responses
       to PHA and MLC were in Grade C, the survival was 22 months. Severe
       immune defects in the first year of life in children with HIV infection,
       as assessed by CD4 counts and a battery of functional tests, predicted
       rapid disease progression.
 DE    Age Factors  Cell Division  Child  Child, Preschool  CD4 Lymphocyte
       Count  Disease Progression  Female  Human  HIV Infections/DRUG
       THERAPY/*IMMUNOLOGY  Infant  Lymphocytes/*IMMUNOLOGY  Male  Support,
       U.S. Gov't, P.H.S.  Survival Analysis  Treatment Outcome  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).