Prognostic significance of immunologic changes in 675 infants perinatally exposed to human immunodeficiency virus

Maurizio de Martino, Pier Angelo Tovo, Luisa Galli, Clara Gabiano, Sandra Cozzani, Cristina Gotta, Gabriella Scarlatti, Alessandro Fiocchi, Pietro Cocchi, Paola Marchisio, Roberto Canino, Angelina Mautone, Franco Chiappe, Antonio Campelli, Rita Consolini, Giancarlo Izzi, Annamaria Laverda, Silvano Alberti, Alberto Eugenio Tozzi, Marzia Duse

Research output: Contribution to journalArticlepeer-review

Abstract

Neutrophil, lymphocte, and T-cell subset numbers and immunoglobulin levels were evaluated at birth to age 2 years in 675 children born to mothers infected with the human immunodeficiency virus type 1 (58 infected symptom-free subjects (P-1), 203 infected subjects with symptoms (P-2), and 414 uninfected subjects). The P-2 patients had (even at birth to age 1 month) lower CD4+ lymphocyte and higher IgA and IgM values than P-1 and uninfected children had. Increased IgG values (from 1 to 6 months of age) and increased CD8 + lymphocyte numbers (at 13 to 24 months of age) were also observed. The P-1 children differed from uninfected children only at 13 to 24 months of age (decreased CD4+ and increased CD8+ lymphocytes). Progressive immunologic changes were found in P-2 patients who had severe clinical conditions and in those who died. To evaluate the predictive meaning of the immunologic changes, we selected 164 children (25 P-2, 15 P-1, and 124 uninfected children) because they had been examined sequentially from birth and they were classified as in the indeterminate state of infection (P-0) at immunologic evaluations at birth to age 1 and at 1 to 6 months of age. During the 1- to 6-month period, P-2 patients had higher immunoglobulin and lower CD4+ lymphocyte values than P-1 and uninfected children had; no difference was found between P-1 and uninfected subjects. These results indicate that in infants with perinatal human immunodeficlency virus type 1 infection, immunologic abnormalities correlate with the clinical condition and are predictive of the clinical outcome rather than the infection status.

Original languageEnglish
Pages (from-to)702-709
Number of pages8
JournalJournal of Pediatrics
Volume119
Issue number5
DOIs
Publication statusPublished - 1991

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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