Children infected with HIV do not necessarily develop AIDS to a set pattern but can be divided into long-term and short-term survivors. We examined long-term survival in children perinatally infected with HIV-1. Out of a total of 624, we studied 182 children who survived longer than 5 years (long-term survivors [LTS]) and 120 children who died of HIV-1-related disease before 5 years (defined as short-term survivors [STS]). 28 (15%) LTS were symptomless (Centers for Disease Control [CDC] P-1 children). 154 (85%) had symptoms (CDC P-2). The proportion of LTS with less than 0.2 x 10(9)/CD4 cells per L was 24/116 (21%) at 61-72 months, rising to 11/26 (41%) at more than 96 months. On at least one occasion, p24 antigenaemia was observed in 112 (62%) LTS. Annual rate of CD4 cell loss was lower in LTS (25% [95% CI: 21-29]) than in STS (53% [45-60]) and in LTS symptomless or with solitary P-2A signs (17%; [13-21]) than in LTS with severe manifestations (30% [25-35]). A new outlook emerges. A substantial number of children do survive after early childhood; severe diseases; low CD4 cell numbers, and p24 antigenaemia do not necessarily preclude long-term survival. The study shows that a CD4 cell decrease early in life can be predictive of outcome.
Features of children perinatally infected with HIV-1 surviving longer than 5 years. Italian Register for HIV Infection in Children / M., De Martino; Pa, Tovo; L., Galli; C., Gabiano; F., Veglia; C., Giaquinto; S., Tulisso; A., Loy; G., Ferraris; Gv, Zuccotti; M., Clerici Schoeller; A., Vierucci; P., Marchisio; G., Castelli Gattinara; D., Caselli; P., Dallacasa; C., Fundarò; M., Stegagno; G., Anzidei; A., Soresina; F., Chiappe; M., Ruggeri; P., Cocchi; R., Consolini; Pl, Mazzoni; G., Benaglia; S., Risso; F., Ciccimarra; G. L., Forni; V., Portelli; D., De Mattia; A., Mazza; T., Bezzi; A., Corrias; I., Ragazzini; G., Gamberetto; F., Bassanetti; M. T., Cecchi; E., Micheletti; P., Osimani; M., Sticca; L., Tarallo; Guarino, Alfredo; P., Falconieri. - In: THE LANCET. - ISSN 0140-6736. - STAMPA. - 343:(1994), pp. 191-195.
Features of children perinatally infected with HIV-1 surviving longer than 5 years. Italian Register for HIV Infection in Children.
GUARINO, ALFREDO;
1994
Abstract
Children infected with HIV do not necessarily develop AIDS to a set pattern but can be divided into long-term and short-term survivors. We examined long-term survival in children perinatally infected with HIV-1. Out of a total of 624, we studied 182 children who survived longer than 5 years (long-term survivors [LTS]) and 120 children who died of HIV-1-related disease before 5 years (defined as short-term survivors [STS]). 28 (15%) LTS were symptomless (Centers for Disease Control [CDC] P-1 children). 154 (85%) had symptoms (CDC P-2). The proportion of LTS with less than 0.2 x 10(9)/CD4 cells per L was 24/116 (21%) at 61-72 months, rising to 11/26 (41%) at more than 96 months. On at least one occasion, p24 antigenaemia was observed in 112 (62%) LTS. Annual rate of CD4 cell loss was lower in LTS (25% [95% CI: 21-29]) than in STS (53% [45-60]) and in LTS symptomless or with solitary P-2A signs (17%; [13-21]) than in LTS with severe manifestations (30% [25-35]). A new outlook emerges. A substantial number of children do survive after early childhood; severe diseases; low CD4 cell numbers, and p24 antigenaemia do not necessarily preclude long-term survival. The study shows that a CD4 cell decrease early in life can be predictive of outcome.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
