Evaluation of human immunodeficiency virus (HIV) type 1 load, CD4 T cell level, and clinical class as time-fixed and time-varying markers of disease progression in HIV-1 - Infected children

Human immunodeficiency virus (HIV) type 1 RNA load, CD4 T cell level, and C enters for Disease Control and Prevention (CDC) clinical class history were measured as potential correlates of a CDC class C diagnosis or death in 16 5 HIV-l-infected children followed from birth. These covariates were assess ed at fixed "landmark" ages from 6 to 24 months and were also assessed as t ime-varying values, Virus load was associated with progression in all analy ses, even after adjusting for immunologic and clinical status. This confirm s its importance for monitoring pediatric disease progression, CD4 T cell l evel was associated with disease progression in time-varying but not in adj usted landmark analysis, suggesting that CD4 cells reflects immediate risk more than long-term risk, The distinction between clinical class B and lowe r classes is prognostic during the first 18 months of life; class C versus classes N/A/B becomes more important as the patient ages. Virologic, immuno logic, and clinical status all provide information regarding disease progre ssion risk.