Objective: The aim of this study was to analyze the prognostic value of the clinical manifestations and of the lymphocyte CD4 count in a cohort of HIV infected children.
Patients and methods: We performed a prospective study in 37 HIV infected children during a 6 year period. We studied the statistical association between mortality and clinical and immunological parameters according to Fisher's test (p < 0.05). We performed a survival analysis according to Kaplan-Meier curves (p < 0.05).
Results: We have found that a high risk of mortality is associated with recurrent and severe bacterial infections (p = 0.0001), failure to thrive (p = 0.0057), opportunistic infections (p = 0.0008) and AIDS (p < 0.0001). The survival analysis has shown a low probability of survival in HIV-encephalopathy (p = 0.000053) and high in one case of lymphocytic interstitial pneumonia (p = 0.07). An age-related CD4 count less than 2 SD was associated significantly with a bad prognosis (p = 0 .0017).
Conclusions: The clinical manifestations and age-matched CD4 count continue being good surrogate markers for the indication of prophylaxis, antiretroviral treatment and as prognostic values of the disease in HIV infected children until new techniques, especially plasma viremia, can be widely available.