AEGiS-13IAC: Natural history of perinatally HIV-1 infected children older than six years with CD4+ counts < 100 cells/mm3.

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METHODS: Clinical and laboratory data were obtained from medical records of HIV-1 infected children followed at the University of Miami through July, 1997" /> AEGiS-13IAC: Natural history of perinatally HIV-1 infected children older than six years with CD4+ counts < 100 cells/mm3.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Natural history of perinatally HIV-1 infected children older than six years with CD4+ counts < 100 cells/mm³.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrB113)

De Souza R, Gomez-Marin O, Hutto C, Scott G, Guasti S, Mitchell C
R. De Souza, Universidade de Caxias do Sul, Os 18 do Forte 1560, 401, Caxias do Sul - RS, 95020-471, Brazil, Tel.: +55 542 234 998, Fax: +55 542 231 528, E-mail: salubrit@zaz.com.br

BACKGROUND: To describe the clinical and immunologic characteristics and survival of HIV-1 infected children >6 yrs. old once their CD4+ counts reach >100 cells/mm³.

METHODS: Clinical and laboratory data were obtained from medical records of HIV-1 infected children followed at the University of Miami through July, 1997. Eligible patients were perinatally HIV-1 infected children six years or older who had at least two consecutive absolute CD4+ counts >100 cells/mm³. Participants were divided into two Groups: G1 (n = 29), children who survived >24 months (mos); and G2 (n = 33) children who survived >24 mos. after their second consecutive CD4>100. Groups were compared with respect to median time to the event (CD4>100), survival time after CDC classification, immune status, and use of antiretroviral and prophylactic agents.

RESULTS: Of 682 children, 62 (9%) were elegible. Overall mean follow-up was 65 mos. (median 63).Mean age at presentation was G1: 42 mos; G2: 57 mos. Mean age at the time of CD4>100 was 83 mos. in G1 and 90 mos. in G 2, (p = 0.36). Survival with CD4 > 100 for the entire group: mean = 28 mos., median = 26 mos. (G1:15 mos.; G2: 39 mos.; p = 0.001). 47 (76%) patients had died and 15 (24%) were alive at the cut off date. No significant differences were found in CDC classification or immunological parameters between groups, however there was a significant association with respect to the age of the first AIDS defining condition (G1: 48 mos; G2: 76 mos; p = 0.035). All children were receiving antiretroviral therapy and Pneumocystis carinii pneumonia (PCP) prophylaxis. The most common Aids-defining conditions were recurrent bacterial infections, lymphoid interstitial pneumonitis, esophageal candidiasis and PCP. Recurrent bacterial infections was the most common cause of death.

CONCLUSION: Overall survival in HIV-1 infected children with absolute CD4 >100 was 15/62 (24%) and correlated with an older age at the occurrence of the first AIDS defining condition.

Keywords: AEGIS, CD4 Lymphocyte Count, HIV-1, Pneumonia, Pneumocystis, Acquired Immunodeficiency Syndrome, Natural History, Time, Time Factors, Child, Human
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