BETA-2-MICROGLOBULIN AND CD4 CD8 RATIO AS HIV-1 MARKERS OF MATERNAL TRANSMISSIBILITY, NEONATAL INFECTION AND DISEASE PROGRESSION/

A hospital-based cohort study assessing the function of surrogate mark ers (beta(2)-microglobulin and CD4/CD8 ratio) in predicting maternal H IV transmissibility and disease progression in infants was conducted i n 110 seropositive black South African mother-infant pairs. There were no differences in beta(2)-microglobulin (beta(2)-M) levels between th e 27 transmitting and 83 non-transmitting mothers (p = 0.36). beta(2)- M levels were higher in the infected than in the uninfected infants, b ut were significantly higher at 1 month (p = 0.04) and again at 12 mon ths (0.03). A CD4/CD8 ratio < 1 was increasingly reported in the infec ted infants from 3 months (60.9%) to 15 months (93.8%) of age, and in three (5.4%) uninfected infants. Of the eight infected infants who rap idly progressed to death by 9 months, increased beta(2)-M levels at bi rth and 1 month and inverted CD4/CD8 ratios at 3 months were strongly associated with the objective morbidity score. However, the CD4/CD8 ra tio (positive predictive value 82.4%, negative predictive value 82.8%) at 3 months or later remained a better indicator of disease progressi on than beta(2)-M (positive predictive value 33.3%, negative predictiv e value 74.4%).