Int Conf AIDS. 1996 Jul 7-12;11(2):116 (abstract no. We.B.3338). Unique
Objective: To evaluate the clinical progression and survival of
HIV-infected children with very low CD4 cell counts as a potential focus
population for antiviral and immune therapy modalities. Methods: A
retrospective chart review was performed of children followed from 1987
to 1995. Survival times [from time CD4 counts fell below 100/cu mm to
outcomes (i.e. death)] were estimated with Kaplan-Meier methods.
Results: For 42 perinatally-infected children, CD4 counts fell less than
100 at a median age of 2.2 years (range=3 weeks-7.4 years), with a
median survival time after CD4 less than 100 of 1.3 years. There was a
relatively larger proportion of encephalopathy and opportunistic
infections in children with CD4 less than 100 below age 3 years than
above. Survival analysis showed a trend toward longer survival for
children with CD4 less than 100 after age 3 (median survival=2.3 years).
The median survival was 1.2 years for CD4 less than 100 before age 3
years (p= 0.04, Log-Rank; p= 0.14, Wilcoxon)]. Survival was
significantly shorter for infants with CD4 less than 100 before 1 year
of age (median survival = 0.96 years), compared to ages 1-2 years and
above 2 years (p=0.016). table: see text) Conclusion: There are
differences in survival and clinical progression of children with very
low CD4 counts relative to the age at which they drop, most notably in
children within the first year of life. These findings correlate with
the immune pattern of thymic deficiency that we have recently
demonstrated in infants less than 1 year of age.