Prognostic markers of progression to aids in infants vertically infected by human immunodeficiency virus type-1

BACKGROUND: TO study the prognostic AIDS progression value of the percentag e of CD4+, CD8+, and plasma viral load (VL) (copies/ml) in HIV-l-vertically infected children. PATIENTS AND METHOD: We study a cohort of 115 HIV-1 infected children older than 12 months of age. The VL was quantified using standard molecular assa y. CD4 and CD8 T lymphocytes were determined by flow cytometry. RESULTS: The children with a median of VL > 4.5 log10 (p < 0.001) and perce ntage of CD8+ < 25% (p = 0.05) during follow-up, progressed faster to AIDS than children with a median of VL < 4.5 log10 and CD8 > 25%. The relative r isk (RR) of AIDS progression was 7-fold higher in children with median VL a bove 4.5 log,,. When considering VL as a continuous variable, risk of progr ession to AIDS is 3.5-fold higher for each increase of one log,, of VL. The percentage of CD8+ T-cells had a RR of AIDS progression of 0.95/% CD8+ at entry to the study and of 0.19/% CD8+ during follow-up, indicating protecti on against progression to AIDS. CONCLUSIONS: Our results indicate that each basal values at entry in the st udy and during the follow-up of the percentage of CD8+ and VL helps to dete rmine the risk of AIDS progression in HIV-l-infected children. More interes tingly, the use of the two predictive markers together had higher predictiv e value.