SERUM BETA-2-MICROGLOBULIN LEVELS AS INDICATORS OF HIV DISEASE-ACTIVITY IN CHILDREN

Identification of laboratory tests that predict progression to acquire d immunodeficiency syndrome (AIDS) in human immunodeficiency virus. (H IV)infected children would be useful for clinical management. Quantita tion of CD4(+) T-cell number (CD4#) and percents (CD4%), HIV p24 antig en (p24) levels, and erythrocyte sedimentation rate (ESR) have been us ed to monitor HIV infection and disease progression. beta-2-Microglobu lin (B(2)M) concentration reflects the degree of immune system activat ion. In adults high levels of B(2)M predict HIV disease progression. T he present study was performed to identify laboratory markers that cor relate with HIV disease activity in children, to determine if B(2)M re flects HIV disease activity better than the other surrogate markers te sted, and to evaluate if serum B(2)M is elevated in asymptomatic compa red with symptomatic HIV-infected children. Sera from 44 HIV-infected children were selected for measurement of B(2)M levels concurrently wi th p24 levels. ESR, CD4#, and CD4% were tested within one month of the B(2)M measurement. CD4% and ESR correlated best with Centers for Dise ase Control and Prevention (CDC) clinical stage. B(2)M levels were abn ormal earlier in HIV disease than other markers but were elevated in b oth asymptomatic and symptomatic HIV-infected children.