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, P.A. Tovo, L. Galli, C. Gabiano, F. Veglia, C. Giaquinto, S. Tulisso, A. Loy, G. Ferraris, G.V. Zuccotti, M.C. Schoeller, A. Vierucci, P. Marchisio, G.C. Gattinara, D. Caselli, P. Dallacasa, C. Fundarò, M. Stegagno, G. Anzidei, A. Soresina, F. Chiappe, M. Ruggeri, P. Cocchi, R. Consolini, P.L. Mazzoni, G. Benaglia, S. Risso, F. Ciccimarra, G.L. Forni, V. Portelli, D. Demattia, A. Mazza, T. Bezzi, A. Corrias, I. Ragazzini, G. Gambaretto, F. Bassanetti, M.T. Cecchi, E. Micheletti, P. Osimani, M. Sticca, L. Tarallo, A. Guarino, P. Falconieri. - In: THE LANCET. - ISSN 0140-6736. - 343:8891(1994 Jan 22), pp. 191-195. [10.1016/S0140-6736(94)90987-3]
Features of children perinatally infected with HIV-1 surviving longer than 5 years. Italian Register for HIV Infection in Children
L. Galli;G.V. Zuccotti;P. Marchisio;
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.
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
