The effect of plasma human immunodeficiency virus RNA and CD4(+) T lymphocytes on growth measurements of hemophilic boys and adolescents

Objective. The investigation examined the associations of plasma human immu nodeficiency virus (HIV) RNA and CD4(+) T lymphocytes with height, weight, skeletal maturation, testosterone levels, and height velocity for hemophili c children and adolescents with HIV infection in the Hemophilia Growth and Development Study. Study Design. Two hundred seven participants were evaluated over 7 years. Results. A threefold increment in baseline plasma HIV RNA was associated wi th a 0.98-cm decrease in height and a 1.67-kg decrease in weight; 100-cells /muL decrements in baseline CD4(+) were associated with a 2.51-cm decrease in height and a 3.83-kg decrease in weight. Participants with high plasma H IV RNA (> 3125 copies/mL) experienced significant delay in achieving maximu m height velocity and lower maximum velocity compared with those with low v iral load. The high CD4(+) (> 243)/low plasma HIV RNA group had earlier age at maximum height velocity compared with the other 3 groups and higher max imum height velocity compared with the low CD4(+)/high plasma HIV RNA and l ow CD4(+)/low plasma HIV RNA groups. Decrements in CD4(+) were associated w ith decreases in bone age and testosterone level. Conclusions. CD4(+) and HIV RNA were important in predicting growth outcome s.