Predictive value of the HIV paediatric classification system for the long-term course of perinatally infected children

L. Galli, Maurizio de Martino, P. A. Tovo, C. Gabiano, M. Zappa, P. Osimani, D. De Mattia, P. Zizzadoro, M. Ruggeri, F. Baldi, M. Ciccia, P. Dallacasa, M. Masi, L. Battisti, E. Bresciani, M. Duse, S. Timpano, P. G. Chiriacò, M. Belloni, A. CorriasP. Ibba, G. Rossi, E. Anastasio, G. Sabatino, M. Sticca, C. Nasi, T. Bezzi, A. Vierucci, S. Farina, S. Ballotti, D. Bassetti, A. De Maria, G. L. Forni, C. Gotta, M. G. Marazzi, D. Mecca, L. Tasso, U. Tondo, E. Micheletti, G. Gambaretto, M. Cellini, R. Altobelli, A. Bucceri, S. Conio, G. Ferraris, M. Giovannini, R. Lipreri, P. Marchisio, E. Massironi, R. Pinzani, A. Plebani, L. Rancilio, E. Riva, F. Salvini, R. Tornaghi, G. V. Zuccotti, A. Guarino, C. Pignata, C. Giaquinto, O. Rampon, E. M. Ruga, A. Romano, G. Benaglia, D. Caselli, A. Maccabruni, F. Bassanetti, R. Consolini, G. Palla, A. Antonellini, A. M. Metri, C. Magnani, M. T. Cecchi, G. Castelli Gattinara, S. Catania, P. Falconieri, C. Fundarò, O. Genovese, A. Krzisztofiak, S. Livadiotti, C. Rendeli, M. Stegagno, C. Timpano, A. Mazza, C. M. Salvatore, E. Palomba, C. Riva, S. Tulisso, A. Pellegatta

Research output: Contribution to journalArticle

Abstract

Background. To compare the Centers for Disease Control and Prevention (CDC) paediatric classification system with the long-term course of perinatal human immunodeficiency virus type 1 (HIV-1) infection. Methods. Prospective study on 366 perinatally infected children followed-up from birth and checked at least every 2 months. Survival, smoothed hazard, adjusted hazard ratio of death, and transition probabilities in clinical and immunological categories were outcome measures. Results. Survival was 49% (95% CI : 40-58%) at 8 years. The risk of death was high before the age of 2, relatively low between ages 2 and 7, and contained thereafter. Children did not advance through the categories sequentially. Survival at 8 years was 61.7% (95% CI : 49.8-73.6%) in those children who had passed through clinical category A; the hazard ratio of death was 2.5 (95% CI : 1.7-3.8) for 175 (47.9%) children who skipped this category. Transition probability in clinical category B was 39.9% (95% CI : 32.3-45.6%) after one year, but 59.1% (95% CI : 51.4-66.8%) after 5 years. Before 2 years of age, the probability of entry into category C (40%; 95% CI : 35-45%) was higher than that of entry into immunological category 3 (28%; 95% CI : 22-34%). Conclusions. The classification system stands comparison with the clinical reality, but the CD4-positive cell thresholds in infancy should be adjusted and category B indicator diseases better distributed to improve their predictive value.

Original languageEnglish
Pages (from-to)573-578
Number of pages6
JournalInternational Journal of Epidemiology
Volume29
Issue number3
Publication statusPublished - 2000

Keywords

  • CD4-positive lymphocytes
  • CDC paediatric classification system
  • Disease progression
  • Perinatal HIV-1 infection
  • Survival

ASJC Scopus subject areas

  • Epidemiology

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  • Cite this

    Galli, L., de Martino, M., Tovo, P. A., Gabiano, C., Zappa, M., Osimani, P., De Mattia, D., Zizzadoro, P., Ruggeri, M., Baldi, F., Ciccia, M., Dallacasa, P., Masi, M., Battisti, L., Bresciani, E., Duse, M., Timpano, S., Chiriacò, P. G., Belloni, M., ... Pellegatta, A. (2000). Predictive value of the HIV paediatric classification system for the long-term course of perinatally infected children. International Journal of Epidemiology, 29(3), 573-578.