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Evaluation of hematological, virologic and anthropometric parameters as progression markers in HIV-1 infected
Inácio R Carvalho1, Jorge A Pinto, Claudete A A Cardoso
1Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
Insights
Nutritional status and CD4+ T-lymphocyte counts predict disease progression in HIV-infected children over 12 months old. These markers are crucial for assessing risk in pediatric HIV management.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Public Health
Background:
- Human Immunodeficiency Virus (HIV) infection in children presents unique challenges in disease monitoring.
- Identifying reliable markers for disease progression is critical for timely intervention and improved outcomes.
- Previous studies have explored various clinical and laboratory parameters, but their predictive value in different age groups requires further investigation.
Purpose of the Study:
- To evaluate total lymphocyte count, total leukocyte count, hemoglobin, nutritional status, CD4+ T-lymphocyte count, and viral load as predictors of disease progression or death in HIV-infected children.
- To stratify the analysis by age groups to identify age-specific prognostic markers.
Main Methods:
- Retrospective cohort study of antiretroviral-naïve, HIV-infected children (asymptomatic or with mild/moderate symptoms).
- Events of interest included progression to CDC clinical category C or death.
- Analysis included baseline total leukocyte count, total lymphocyte count, hemoglobin, weight-for-age z-score, CD4+ T-lymphocyte count, and plasma viral load, stratified by age (<12, 12-35, 36-59 months).
Main Results:
- In children older than 12 months, CD4+ T-lymphocyte count (WHO categories) and weight-for-age z-score ≤ -2 were significant predictors of disease progression.
- No specific laboratory or nutritional marker was associated with disease progression risk in children younger than 12 months.
- The study included 120 children with a median follow-up of 7.4 months.
Conclusions:
- Nutritional status, specifically weight-for-age z-score, is a key indicator for assessing disease progression risk in HIV-infected children over 12 months.
- CD4+ T-lymphocyte count remains an important prognostic marker in this age group.
- Further research may be needed to identify reliable early markers for disease progression in HIV-infected infants under 12 months.
Objective:
To analyze total lymphocyte count, total leukocyte count, hemoglobin levels, nutritional status, CD4+ T-lymphocyte count and viral load as markers of disease progression and/or death in HIV-infected children.
Methods:
This retrospective cohort study assessed antiretroviral naïve HIV-infected children who were asymptomatic or had mild and/or moderate symptoms. The events of interest were: progression to clinical category C (according to the classification of the Centers for Disease Control and Prevention - CDC, 1994) or death. Values of total leukocyte count, total lymphocyte count, hemoglobin, weight-for-age z score, CD4+ T-lymphocyte count and plasma viral load obtained at admission were considered in the risk analysis of events of interest. The population was stratified into age groups: < 12, >or= 12 to < 36, >or= 36 to < 60 months.
Results:
One hundred and twenty patients, admitted between 1997 and 2003, met the inclusion criteria for the present study. The total median of follow-up duration was 7.4 months (25-75% interquartile range = 3.8-21.1). In the multivariate analysis, only CD4+ T-lymphocytes count, according to the categories of the World Health Organization, and weight-for-age z score
Conclusion:
Nutritional status is an important aspect in the assessment of risk of disease progression in HIV-infected children older than 12 months.
