Background To compare the Centers for Disease Control and Prevention (CDC) paediatric classification system with the long-term course of perinatal human immunodeficiency virus type 1 (HIV-1) infection. Methods Prospective study on 366 perinatally infected children followed-up from birth and checked at least every 2 months. Survival, smoothed hazard, adjusted hazard ratio of death, and transition probabilities in clinical and immunological categories were outcome measures. Results Results Survival was 49% (95% CI : 40-58%) at 8 years. The risk of death was high before the age of 2, relatively low between ages 2 and 7, and contained thereafter. Children did not advance through the categories sequentially. Survival at 8 years was 61.7% (95% CI : 49.8-73.6%) in those children who had passed through clinical category A; the hazard ratio of death was 2.5 (95% CI : 1.7-3.8) for 175 (47.9%) children who skipped this category. Transition probability in clinical category B was 39.9% (95% CI : 32.3-45.6%) after one year, but 59.1% (95% CI : 51.4-66.8%) after 5 years. Before 2 years of age, the probability of entry into category C (40%; 95% CI: 35-45%) was higher than that of entry into immunological category 3 (28% 95% CI : 22-34%). Conclusions The classification system stands comparison with the clinical reality, but the CD4-positive cell thresholds in infancy should be adjusted and category B indicator diseases better distributed to improve their predictive value.
|Autori:||Italian Register for HIV Infection in Children. Wriiting Committee: Galli; L; : De Martino; M; Tovo; PA; Gabiano; C; Zappa; M Partecipants: Osimani; P; De Mattia; D; Zizzadoro; P; Ruggeri; M; Baldi; F; Ciccia; M; Dallacasa; P; Masi; M; Battisti; L; Brescaini; E; Duse; M; Timpano; S; Chiriacò; PG; Belloni; M; Corrias; A; Ibba; P; Rossi; G; Anastasio; E; Sabatino; G; Sticca; M; Nasi; C; Bezzi; T; Vierucci; A; Farina; S; Bellotti; S; Bassetti; D; De Maria; A; Forni; GL; Gotta; C; Marazzi; MG; mecca; D; Tasso; L; Tondo; U; Micheletti; E; Pinzani; R; Plebani; A; Rancilio; L; Riva; E; Salvini; S; Tornaghi; R; zuccotti; GV; Guarino; A; Pignata; C; Giaquinto; C; Rampon; O; Ruga; EM; Romano; A; Benaglia; G; Caselli; D; Maccabruni; A; Bassanetti; F; Consolini R; et al|
|Titolo:||Predictive value of the HIV paediatric classification system for the long-term course of perinatally infected children|
|Anno del prodotto:||2000|
|Appare nelle tipologie:||1.1 Articolo in rivista|