Open Access
Subscription or Fee Access
CD4T LYMPHOCYTE SUBSETS AND DISEASE MANIFESTATION IN CHILDREN WITH AND WITHOUT HIV BORN TO HIV-1 INFECTED MOTHERS
Abstract
ABSTRACT
Objective: To understand the natural history of HIV-1 infection in children in terms
of evolution of childhood clinical manifestations versus the immune status, we prospectively
studied children with and without maternally transmitted HIV-1 infection born to
mothers infected with HIV-1 for two years between March 1998 and March 2000.
Design: A prospective cohort study.
Setting: An institutional children’s home.
Subjects: Fifty nine children (26 males and 33 females) with and without maternally
transmitted HIV-1 infection born to mothers infected with HIV-1 and adopted in
institutional children home.
Methods: HIV-1 status of children under nine months was confirmed by polymerase
chain reaction(PCR). ELISA for HIV-1 antibody in serum/plasma was used to confirm
HIV-infection status for children aged £18 months. Children were visited every three
months between March and June 2000. At every visit blood was collected for total white
cell count, haemoglobin and CD4+ and CD8+ T cell counts. The institutional doctor
routinely examined children and treated all ailments. Clinical data were recorded.
Measures: HIV-DNA, anti-HIV antibodies, total white blood count, total T cell counts,
CD4 and CD8 T cell subset counts, frequency of childhood manifestations of infection.
Results: The children were aged between 4.5 and 13 years. The baseline haematological
and immunological profiles (mean, mode) were: HIV-1 sero-converters (WBC 7151,7150;
HB 11.6, 12.0; CD4+ 686, 795; CD8+ 2168, 1507) and HIV-1 de-seroconverters (mean,
mode) were: (WBC 8386, 7150; HB 11.7, 12.8; CD4+ 735, 795; CD8+ 2168, 1507). The
commonest causes of illnesses among the HIV-1 children were URTI (85.3%), TB(56.1%),
pneumonia (56.2%), tonsillitis (34.1%), parotiditis (28%) and acute otitis media (25%).
The distribution of clinical manifestations was similar between the two categories of
children, except URTI, whose prevalence was significantly increased among HIV-1
infected children (p-value=0.006). Among the HIV-1 infected children, only TB,
parotiditis, and acute otitis media (AOM) were significantly associated with decreased
CD4+ T cell count (p<0.05) resulting from HIV infection.
Conclusions: HIV infection in children predisposes them to common childhood infections
that can be used as markers of immune decline. TB, AOM, URTI may be early indicators
of suspicion that would enable selective screening for HIV infection in children.
Objective: To understand the natural history of HIV-1 infection in children in terms
of evolution of childhood clinical manifestations versus the immune status, we prospectively
studied children with and without maternally transmitted HIV-1 infection born to
mothers infected with HIV-1 for two years between March 1998 and March 2000.
Design: A prospective cohort study.
Setting: An institutional children’s home.
Subjects: Fifty nine children (26 males and 33 females) with and without maternally
transmitted HIV-1 infection born to mothers infected with HIV-1 and adopted in
institutional children home.
Methods: HIV-1 status of children under nine months was confirmed by polymerase
chain reaction(PCR). ELISA for HIV-1 antibody in serum/plasma was used to confirm
HIV-infection status for children aged £18 months. Children were visited every three
months between March and June 2000. At every visit blood was collected for total white
cell count, haemoglobin and CD4+ and CD8+ T cell counts. The institutional doctor
routinely examined children and treated all ailments. Clinical data were recorded.
Measures: HIV-DNA, anti-HIV antibodies, total white blood count, total T cell counts,
CD4 and CD8 T cell subset counts, frequency of childhood manifestations of infection.
Results: The children were aged between 4.5 and 13 years. The baseline haematological
and immunological profiles (mean, mode) were: HIV-1 sero-converters (WBC 7151,7150;
HB 11.6, 12.0; CD4+ 686, 795; CD8+ 2168, 1507) and HIV-1 de-seroconverters (mean,
mode) were: (WBC 8386, 7150; HB 11.7, 12.8; CD4+ 735, 795; CD8+ 2168, 1507). The
commonest causes of illnesses among the HIV-1 children were URTI (85.3%), TB(56.1%),
pneumonia (56.2%), tonsillitis (34.1%), parotiditis (28%) and acute otitis media (25%).
The distribution of clinical manifestations was similar between the two categories of
children, except URTI, whose prevalence was significantly increased among HIV-1
infected children (p-value=0.006). Among the HIV-1 infected children, only TB,
parotiditis, and acute otitis media (AOM) were significantly associated with decreased
CD4+ T cell count (p<0.05) resulting from HIV infection.
Conclusions: HIV infection in children predisposes them to common childhood infections
that can be used as markers of immune decline. TB, AOM, URTI may be early indicators
of suspicion that would enable selective screening for HIV infection in children.
Refbacks
- There are currently no refbacks.
