Immunological manifestations of HIV-infected children

This cross-sectional study of stable HIV-infected children was designed to document the immunological manifestations of paediatric HIV infection and t o determine whether inexpensive markers of immunosuppression could be ident ified. Investigations included lymphocyte count and subset analysis, levels of total protein, albumin, immunoglobulins, beta-2 microglobulin and neopt erin. The median age of the 74 children studied was 16.5 months and 76% and 39% had subnormal percentage CD4(+) counts and absolute CD4(+) counts, res pectively. According to the Centers for Disease Control (CDC) guidelines, 8 5% were moderately or severely immunosuppressed. The majority had elevated neopterin, beta-2 microglobulin, IgG, IgM and IgA concentrations. The IgG c oncentration correlated positively with total globulin, IgG(1) and IgG(3) c oncentrations. On bivariate analysis, the absolute CD4(+) count correlated positively with total lymphocyte count (r = 0.28 < 0.48 < 0.64) and negativ ely with total IgG concentration (r = -0.47 < -0.27 < -0.04), IgG(1) concen tration (r = - 0.51 < -0.31 < -0.08), and neopterin concentration (r = -0.4 9 < -0.28 < -0.04). There was no correlation between CD4(+) count, total gl obulin or beta-2 microglobulin concentration. On multiple linear regression analysis only the total lymphocyte count correlated with CD4(+) count. Fur thermore, on bivariate analysis total lymphocyte count correlated positivel y with absolute CD8(+) count (r = 0.82 < 0.88 < 0.92). In conclusion, altho ugh there was a positive correlation between absolute CD4(+) count and tota l lymphocyte count, the clinical significance is questionable as the total lymphocyte count correlated more strongly with the absolute CD8(+) count.