Resino S, Bellón J M, Gurbindo D, Ramos J T, Ruiz Contreras J, Muñoz-Fernández M A
Servicio de Inmunología. Hospital General Universitario Gregorio Marañón. Madrid.
Med Clin (Barc). 2000 Nov 4;115(15):564-7. doi: 10.1016/s0025-7753(00)71626-5.
To study the prognostic AIDS progression value of the percentage of CD4+, CD8+, and plasma viral load (VL) (copies/ml) in HIV-1-vertically infected children.
We study a cohort of 115 HIV-1 infected children older than 12 months of age. The VL was quantified using standard molecular assay. CD4 and CD8 T lymphocytes were determined by flow cytometry.
The children with a median of VL > 4.5 log10 (p < 0.001) and percentage of CD8+ < 25% (p = 0.05) during follow-up, progressed faster to AIDS than children with a median of VL < 4.5 log10 and CD8 > 25%. The relative risk (RR) of AIDS progression was 7-fold higher in children with median VL above 4.5 log10. When considering VL as a continuous variable, risk of progression to AIDS is 3.5-fold higher for each increase of one log10 of VL. The percentage of CD8+ T-cells had a RR of AIDS progression of 0.95/% CD8+ at entry to the study and of 0. 19/% CD8+ during follow-up, indicating protection against progression to AIDS.
Our results indicate that each basal values at entry in the study and during the follow-up of the percentage of CD8+ and VL helps to determine the risk of AIDS progression in HIV-1-infected children. More interestingly, the use of the two predictive markers together had higher predictive value.
研究人类免疫缺陷病毒1型（HIV-1）垂直感染儿童中CD4+、CD8+百分比及血浆病毒载量（VL，拷贝/毫升）对艾滋病进展的预后价值。
我们研究了一组115名年龄超过12个月的HIV-1感染儿童。采用标准分子检测法对病毒载量进行定量。通过流式细胞术测定CD4和CD8 T淋巴细胞。
随访期间病毒载量中位数>4.5 log10（p<0.001）且CD8+百分比<25%（p = 0.05）的儿童，比病毒载量中位数<4.5 log10且CD8+>25%的儿童艾滋病进展更快。病毒载量中位数高于4.5 log10的儿童艾滋病进展的相对风险（RR）高7倍。将病毒载量视为连续变量时，病毒载量每增加1个log10，进展为艾滋病的风险高3.5倍。研究开始时CD8+ T细胞百分比的艾滋病进展RR为0.95/CD8+%，随访期间为0.19/CD8+%，表明可预防进展为艾滋病。
我们的结果表明，研究开始时及随访期间CD8+百分比和病毒载量的每个基础值有助于确定HIV-1感染儿童艾滋病进展的风险。更有趣的是，同时使用这两个预测指标具有更高的预测价值。
