TY - JOUR
T1 - Immunologic Targets of HIV Infection
T2 - T Cells
AU - THE NICHD IVIG CLINICAL TRIAL GROUP
AU - THE NHLBI P2C2 PEDIATRIC PULMONARY AND CARDIAC COMPLICATIONS OF HIV INFECTION STUDY GROUP
AU - Shearer, William T.
AU - Rosenblatt, Howard M.
AU - Schluchter, Mark D.
AU - Mofenson, Lynne M.
AU - Denny, Thomas N.
AU - Peavy, H. H.
AU - Kalica, A.
AU - Kasten-Sportes, C.
AU - Vreirn, C.
AU - Weinstein, C.
AU - Wu, M. C.
AU - Boyett, J.
AU - Schluchter, M.
AU - Moodie, D.
AU - Beck, G.
AU - Baetz-Greenwalt, B.
AU - Easley, K.
AU - Goldfarb, J.
AU - Gragg, L.
AU - McHugh, M.
AU - Mehta, A.
AU - Meziane, M.
AU - Sterba, R.
AU - Houser, H.
AU - Martin, R.
AU - Shearer, W.
AU - Ayers, N.
AU - Baker, C.
AU - Bricker, T.
AU - Demmler, G.
AU - Doyle, M.
AU - Dycon, M.
AU - Garson, A.
AU - Gonik, B.
AU - Hammill, H.
AU - Hansen, T. N.
AU - Hanson, I. C.
AU - Hiatt, P.
AU - Hoots, K.
AU - Jacobson, K.
AU - Kearney, D.
AU - Kline, M. W.
AU - Kozinetz, C.
AU - Langston, C.
AU - Lapin, C.
AU - Ludomirsky, A.
AU - Moore, W.
AU - Pickering, L.
AU - Singleton, E.
AU - Rubinstein, A.
N1 - Funding Information:
This work was supported by National Institutes of Health Grants HR-96040, AI-27551, HD-26603, A1-32466, and a contract from the National Institute of Child Health and Human Development, the Women and Infants HIV Transmision Study, and the Immunology Research Fund of Texas Children's Hospital.
PY - 1993/10
Y1 - 1993/10
N2 - One of the principal targets of HIV infection is the human peripheral blood CD4+ T cell, resulting in progressive CD4+ lymphocyte loss. Hypothesized mechanisms for this loss include apoptosis, cytolytic reactions, V-p gene deletion of the T-cell receptor (TCR) by superantigens, CD4+ lymphocyte syncytium formation, and autoimmune reactions. In adults with HIV infection, the critical decline in CD4+ lymphocyte number that heralds the onset of AIDS-defining conditions is well characterized, whereas in infants and children the critical level of CD4+ cells predisposing to the development of AIDS-defining conditions or mortality is not fully characterized, due to an incomplete knowledge of CD4+ lymphocyte number and changes with age in normal and HIV-infected children. In a prospective study of 317 infants born to HIV-infected women, early results show that the monthly change in absolute CD4+ lymphocyte number over a 3- to 9-month period in HIV-infected infants was - 109 cells/mm3 per month, at least double the rate of decline measured in HIV-noninfected infants in the study or that calculated from normal infants' values reported in the literature. In other clinical studies in HIV-infected infants and children, it was possible to study the effect of low CD4+ cell counts on clinical status and mortality. In HIV-infected pediatric patients younger than 1 year, it was possible to correlate low CD4+ cell number with advanced disease status (CDC pediatric class P-2). It was also possible to correlate extremely low CD4+ cell counts (<200 cells/mm3) in HIV-infected children with a significant risk of mortality within the next 3 months of life. Sequential CD4+ cell analysis of HlV-high-risk infants will delineate the rate of HIV-related decline in CD4+ cells, thus facilitating the diagnosis of HIV infection and aiding in identification of HIV-infected children at high risk of disease progression or death.
AB - One of the principal targets of HIV infection is the human peripheral blood CD4+ T cell, resulting in progressive CD4+ lymphocyte loss. Hypothesized mechanisms for this loss include apoptosis, cytolytic reactions, V-p gene deletion of the T-cell receptor (TCR) by superantigens, CD4+ lymphocyte syncytium formation, and autoimmune reactions. In adults with HIV infection, the critical decline in CD4+ lymphocyte number that heralds the onset of AIDS-defining conditions is well characterized, whereas in infants and children the critical level of CD4+ cells predisposing to the development of AIDS-defining conditions or mortality is not fully characterized, due to an incomplete knowledge of CD4+ lymphocyte number and changes with age in normal and HIV-infected children. In a prospective study of 317 infants born to HIV-infected women, early results show that the monthly change in absolute CD4+ lymphocyte number over a 3- to 9-month period in HIV-infected infants was - 109 cells/mm3 per month, at least double the rate of decline measured in HIV-noninfected infants in the study or that calculated from normal infants' values reported in the literature. In other clinical studies in HIV-infected infants and children, it was possible to study the effect of low CD4+ cell counts on clinical status and mortality. In HIV-infected pediatric patients younger than 1 year, it was possible to correlate low CD4+ cell number with advanced disease status (CDC pediatric class P-2). It was also possible to correlate extremely low CD4+ cell counts (<200 cells/mm3) in HIV-infected children with a significant risk of mortality within the next 3 months of life. Sequential CD4+ cell analysis of HlV-high-risk infants will delineate the rate of HIV-related decline in CD4+ cells, thus facilitating the diagnosis of HIV infection and aiding in identification of HIV-infected children at high risk of disease progression or death.
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U2 - 10.1111/j.1749-6632.1993.tb26255.x
DO - 10.1111/j.1749-6632.1993.tb26255.x
M3 - Article
C2 - 7903519
AN - SCOPUS:0027451662
SN - 0077-8923
VL - 693
SP - 35
EP - 51
JO - Annals of the New York Academy of Sciences
JF - Annals of the New York Academy of Sciences
IS - 1
ER -