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Evaluation of Immune Survival Factors in Pediatric HIV‐1 Infection
Author(s) -
SHEARER WILLIAM T.,
EASLY KIRK A.,
GOLDFARB JOHANNA,
JENSON HAL B.,
ROSENBLATT HOWARD M.,
KOVACS ANDREA,
MCINTOSH KENNETH
Publication year - 2000
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2000.tb05499.x
Subject(s) - cd8 , immunology , cd19 , lactate dehydrogenase , immune system , medicine , antibody , albumin , cd4 cd8 ratio , hemoglobin , biology , lymphocyte subsets , biochemistry , enzyme
A bstract : Peripheral blood CD4 + and CD8 + T cells, CD19 + /20 + B cells, and serum immunoglobulins (Igs) have been implicated as survival factors for pediatric HIV‐1 infection. To determine which of these immune factors might be important in predicting survival, we studied HIV‐1 vertically infected (HIV‐1 + ) children over a 5‐year period. Peripheral blood lymphocytes and Igs were measured in 298 HIV‐1 + children, who were classified as survivors or nonsurvivors, and in 463 HIV‐1 vertically exposed and noninfected (HIV‐1 − ) children. Measurements of other possible survival factors were included in this study: albumin, hemoglobin, lactic dehydrogenase (LDH), and HIV‐1 RNA levels. Survivors had significantly higher CD4 + T‐cell, CD8 + T‐cell, and CD19 + /CD20 + B‐cell counts and serum IgG levels, but lower serum IgA and IgM levels than nonsurvivors. Serum albumin and blood hemoglobin levels were higher, but serum LDH and HIV‐1 RNA levels were lower in the survivors compared to non‐survivors. In univariable analysis, factors affecting survival were baseline CD4 + T‐cell and CD8 + T‐cell counts, IgG, albumin, hemoglobin, LDH, and HIV‐1 RNA (all p < 0.001 ). In multivariable analysis, high baseline CD4 + T‐cell count, IgG and albumin levels, and low baseline HIV‐1 RNA load remained important factors for survival. Serum IgG level has been identified as an immune factor that independently predicts survival, in addition to the already established CD4 + T‐cell count. The HIV‐1 RNA and serum albumin levels also predicted survival.