Prospective study of human immunodeficiency virus 1-related disease among 512 infants born to infected women in New York City
| Autor: | Margaret C. Heagarty, Richard W. Steketee, Pamela B. Matheson, Genevieve Lambert, Keith Krasinski, Pauline A. Thomas, Jeremy Weedon, Mahrukh Bamji, Donald M. Thea, Elaine J. Abrams |
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| Rok vydání: | 1996 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Pregnancy Pediatrics business.industry Incidence (epidemiology) medicine.disease Infant mortality Infectious Diseases Acquired immunodeficiency syndrome (AIDS) Pediatrics Perinatology and Child Health Epidemiology Cohort medicine Prospective cohort study business Survival analysis |
| Zdroj: | The Pediatric Infectious Disease Journal. 15:891-898 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/00006454-199610000-00012 |
| Popis: | Objective. To determine the incidence of HIV-1-related clinical findings, mortality and predictors of death in a cohort of HIV-exposed infants followed from birth. Methods. Data were collected approximately bimonthly during the first and second year of life and used in Kaplan-Meier and Cox proportional hazards survival analyses to predict time to the development of symptoms and death. Results. One hundred sixteen infected and 396 uninfected infants were followed for a median of 26 months at 7 New York City hospitals from 1986 to 1995. Two or more nonspecific HIV-related symptoms, AIDS or death occurred in 83% of infected children by the first year. Fifty infected infants (43%) developed AIDS and 19 (38%) of these had Pneumocystis carinii pneumonia. Estimated median age at AIDS/death was 30 months and 64% of infected children remained alive and AIDS-free at 1 year. Estimated infant mortality among infected children was 160/1000 live births, and median survival after AIDS was 21 months ; 55% of infected children survived >12 months after diagnosis of AIDS. P. carinii pneumonia was the most common cause of death. Although birth CD4 values did not predict AIDS or death, CD4 counts as early as 6 months of age were highly correlated with both. Thirteen (68%) of 19 infants who remained AIDS-free up to 3 to 6 months of age with CD4 count ≤1500 cells/μl subsequently developed AIDS vs. 18 (30%) of 61 with CD4 count >1500 (P = 0.0001). Conclusions. Most HIV-1-infected infants develop disease in the first year of life. AIDS or death can be predicted by a threshold CD4 count of 1500 cells/μl at 3 to 6 months of age. |
| Databáze: | OpenAIRE |
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