Musoke Philippa M, Young Alicia M, Owor Maxensia A, Lubega Irene R, Brown Elizabeth R, Mmiro Francis A, Mofenson Lynne M, Jackson J Brooks, Fowler Mary Glenn, Guay Laura A
Department of Paediatrics and Child Health, Makerere University, Kampala, Uganda.
J Acquir Immune Defic Syndr. 2008 Oct 1;49(2):171-8. doi: 10.1097/QAI.0b013e318183a92a.
To determine the utility of total lymphocyte count (TLC) in predicting the 12-month mortality in HIV-infected Ugandan children and to correlate TLC and CD4 cell %.
This is a retrospective data analysis of clinical and laboratory data collected prospectively on 128 HIV-infected children in the HIV Network for Prevention Trials 012 trial.
TLC and CD4 cell % measurements were obtained at birth, 14 weeks, and 12, 24, 36, 48, and 60 months of age and assessed with respect to risk of death within 12 months.
Median TLC per microliter (CD4 cell %) was 4150 (41%) at birth, 4900 (24%) at 12 months, 4300 (19%) at 24 months, 4150 (19%) at 36 months, 4100 (18%) at 48 months, and 3800 (20%) at 60 months. The highest risk of mortality within 12 months was 34% - 37% at birth and declined to 13%-15% at 24 months regardless of TLC measurement. The correlation between CD4 cell % and TLC was extremely low overall (r = 0.01).
The TLC did not predict a risk of progression to death within 12 months in HIV-infected Ugandan children. Therefore, TLC alone may not be a useful surrogate marker for determining those children at highest risk of death, who require antiretroviral therapy most urgently.
确定全淋巴细胞计数（TLC）在预测乌干达感染HIV儿童12个月死亡率方面的效用，并将TLC与CD4细胞百分比进行关联分析。
这是一项对在预防试验HIV网络012试验中前瞻性收集的128例感染HIV儿童的临床和实验室数据进行的回顾性数据分析。
在出生时、14周龄以及12、24、36、48和60月龄时获取TLC和CD4细胞百分比测量值，并评估12个月内的死亡风险。
每微升的TLC中位数（CD4细胞百分比）在出生时为4150（41%），12个月时为4900（24%），24个月时为4300（19%），36个月时为4150（19%），48个月时为4100（18%），60个月时为3800（20%）。无论TLC测量值如何，12个月内最高死亡率在出生时为34% - 37%，在24个月时降至13% - 15%。总体而言，CD4细胞百分比与TLC之间的相关性极低（r = 0.01）。
TLC无法预测乌干达感染HIV儿童在12个月内进展至死亡的风险。因此，仅TLC可能不是确定那些死亡风险最高、最急需抗逆转录病毒治疗儿童的有用替代指标。
