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% Cl: 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.
|Autori:||THE ITALIAN REGISTER FOR HIV INFECTION IN CHILDREN Coordinators: DE MARTINO; M; TOVO; PA; Collaborators: GALLI; L; GABIANO; C; VEGLIA; F; GIAQUINTO; C; TULISSO; S; LOY; A; FERRARIS; G; ZUCCOTTI; GV; SCHOELLER; MC; VIERUCCI; A; MARCHISIO; P; GATTINARA; GC; CASELLI; D; DALLACASA; P; FUNDARO; C; STEGAGNO; M; ANZIDEI; G; SORESINA; A; CHIAPPE; F; RUGGERI; M; COCCHI; P; CONSOLINI R; et al|
|Titolo:||FEATURES OF CHILDREN PERINATALLY INFECTED WITH HIV-1 SURVIVING LONGER THAN 5 YEARS|
|Anno del prodotto:||1994|
|Appare nelle tipologie:||1.1 Articolo in rivista|