AEGiS-14IAC: CD4 cell counts in children born to HIV infected women in Europe.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

CD4 cell counts in children born to HIV infected women in Europe.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10212)

Gray L, European Collaborative Study TH
Institute of Child Health, London, United Kingdom

BACKGROUND: Little is known about the pattern of CD4 cell count in HIV infected children over age, but the commonly used CDC immune categories based on CD4 counts are not reliably associated with clinical progression. There is a lack of data of the development of immune system in uninfected children.

METHODS: Serial information is available on infected and uninfected children enrolled in the prospective European Collaborative Study. A model is identified for the CD4 cell count data of the uninfected children which is then used for comparison of the pattern over age of the infected children. As a first approach fractional polynomial models accounting for repeated measures are used to ascertain the appropriate linear predictor for CD4 in terms of age. Possible differentials by gestational age, gender, maternal characteristics and antiretroviral therapy will be investigated.

RESULTS: Analysis is based on 8,273 CD4 cell count measurements from 1,502 uninfected and 3,059 from 184 infected children ranging in age from 1 day to 15.6 years at their last blood test. A model obtained for data of the uninfected children involved a term in ln of age and square root of age representing an initial increase to peak around 3 months and subsequent two slope concave gradual decline. The pattern for infected children was distinctly different with a high near birth, a decline to age 5 years and some evidence of an upward slope from around age eight. Early analysis would indicate there are no pattern differentials by gender or gestational age in uninfected children.

CONCLUSIONS: Patterns of CD4 cell count data differ between infected and uninfected children, with little evidence of gender based cellular immunity differences in the latter. HIV infection seems to impact on CD4 cell count immediately after birth, whereas the suggestion of an upturn from age eight could be due to effective treatment.

Keywords: AEGIS, CD4 Lymphocyte Count, HIV Infections, HIV Seropositivity, Prospective Studies, Europe, Child, Adult, Human, Female, pathogenicity

020707
B10212