CD4 T cell count as predictor of Pneumocystis carinii pneumonia in children born to mothers infected with HIV

David Dunn, Marie Louise Newell, Tony Ades, Catherine Peckham, Andrea De Maria

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Objective - To assess the value of CD4 T cell count in predicting Pneumocystis carinii pneumonia in infants born to mothers infected with HIV, with reference to the guidelines from the Centers for Disease Control on prophylaxis against pneumocystis. Design - Prospective birth cohort study. Setting - Hospitals in 10 European cities participating in the European collaborative study. Subjects - 924 children born to mothers known to be infected with HIV at or before delivery. Main outcome measures - The incidence of P carinii pneumonia. CD4 T cell counts in children before diagnosis of the pneumonia. The proportions of children infected and uninfected with HIV who fulfilled the criteria for primary prophylaxis. Results - Fourteen children were diagnosed with P carinii pneumonia. The cumulative incidence by the age of 6 years was 2% (95% confidence interval 0.9 to 3.0%). Of the 11 children with a CD4 T cell count predating diagnosis, only three filfilled the criteria from the Centers for Disease Control for prophylaxis. Prophylaxis was indicated by 1 year of age for 62% of infected children who had not developed P carinii pneumonia and for at least 10% of uninfected children. Conclusions - Monitoring CD4 T cell count seems to be of limited value in deciding when to start prophylaxis against P carinii pneumonia in children born to mothers infected with HIV. The alternative approach of giving prophylaxis to all children born to infected mothers would be difficult to justify given the low incidence of the pneumonia.

Original languageEnglish
Pages (from-to)437-440
Number of pages4
JournalBritish Medical Journal
Volume308
Issue number6926
Publication statusPublished - Feb 12 1994

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Pneumocystis carinii
Pneumocystis Pneumonia
CD4 Lymphocyte Count
pneumonia
T-lymphocytes
Mothers
disease control
HIV
T-Lymphocytes
Pneumonia
Centers for Disease Control and Prevention (U.S.)
incidence
Incidence
Pneumocystis
cohort studies
confidence interval
Cohort Studies
Outcome Assessment (Health Care)
Parturition
Guidelines

ASJC Scopus subject areas

  • Medicine(all)
  • Agricultural and Biological Sciences(all)

Cite this

CD4 T cell count as predictor of Pneumocystis carinii pneumonia in children born to mothers infected with HIV. / Dunn, David; Newell, Marie Louise; Ades, Tony; Peckham, Catherine; De Maria, Andrea.

In: British Medical Journal, Vol. 308, No. 6926, 12.02.1994, p. 437-440.

Research output: Contribution to journalArticle

Dunn, David ; Newell, Marie Louise ; Ades, Tony ; Peckham, Catherine ; De Maria, Andrea. / CD4 T cell count as predictor of Pneumocystis carinii pneumonia in children born to mothers infected with HIV. In: British Medical Journal. 1994 ; Vol. 308, No. 6926. pp. 437-440.
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