Immunological characteristics of HIV-infected children

Relationship to age, CD4 counts, disease progression, and survival

N. Chirmule, M. Lesser, A. Gupta, M. Ravipati, N. Kohn, Savita G Pahwa

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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 infectious (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.

Original languageEnglish
Pages (from-to)1209-1219
Number of pages11
JournalAIDS Research and Human Retroviruses
Volume11
Issue number10
StatePublished - Nov 15 1995
Externally publishedYes

Fingerprint

CD4 Lymphocyte Count
Disease Progression
HIV
Survival
Accidental Falls
CD4-CD8 Ratio
Isoantigens
Immune System Diseases
Tetanus
T-Lymphocyte Subsets
Mitogens
Candida
HIV Infections
Acquired Immunodeficiency Syndrome
Age Groups
Biomarkers
Antigens

ASJC Scopus subject areas

  • Immunology
  • Virology

Cite this

Immunological characteristics of HIV-infected children : Relationship to age, CD4 counts, disease progression, and survival. / Chirmule, N.; Lesser, M.; Gupta, A.; Ravipati, M.; Kohn, N.; Pahwa, Savita G.

In: AIDS Research and Human Retroviruses, Vol. 11, No. 10, 15.11.1995, p. 1209-1219.

Research output: Contribution to journalArticle

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