Disease progression in a cohort of infants with vertically acquired HIV infection observed from birth: the Women and Infants Transmission Study (WITS).
Disease progression in a cohort of infants with vertically acquired HIV infection observed from birth: the Women and Infants Transmission Study (WITS).
复制标题
从出生起观察到的一组垂直获得性 HIV 感染婴儿的疾病进展：妇女和婴儿传播研究 (WITS)。
DOI：
10.1097/00042560-199807010-00004
复制
发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Lew,JF
中科院分区：
文献类型：
--
作者：
Diaz,C;Hanson,C;Cooper,ER;Read,JS;Watson,J;Mendez,HA;Pitt,J;Rich,K;Smeriglio,V;Lew,JF
背景：妇女和婴儿传播研究是一项正在进行的hiv感染孕妇及其婴儿的前瞻性队列研究。我们使用1994年美国疾病控制和预防中心（CDC）儿童HIV感染的分类系统来描述128名HIV感染儿童的HIV疾病进展，并检查与病程相关的母婴特征。方法：采用Kaplan-Meier法计算进入CDC临床A、B、C类（轻、中、重度HIV疾病）的概率；CDC免疫2期和3期；和死亡。使用Cox比例风险模型估计选定预测事件进展的相对风险。结果：中位随访时间为24个月，a、B、C类患者进入临床的中位年龄分别为5、11、48个月。发生B级事件的婴儿进展为C级事件的风险增加（p< 0.05）。001);进展到免疫2期(p<。001)或3 (p<。001);早期培养阳性(前48小时，p<。01;在前7天，p=。03);早期（出生后3个月内）出现淋巴结病变、肝肿大或脾肿大（p< 0.05）。001)。结论：达到特定的临床或免疫阶段是艾滋病进展或死亡的有力预测因素。早发的临床症状（淋巴结病、肝肿大或脾肿大≤3月龄）和早期培养阳性（出生后48小时内或出生后第一周内）定义为疾病进展风险最高的婴儿。
Background:The Women and Infants Transmission Study is an ongoing prospective cohort study of HIV-infected pregnant women and their infants. We used the 1994 US Centers for Disease Control and Prevention (CDC) classification system for HIV infection in children to describe HIV disease progression in 128 HIV-infected children, and examined maternal and infant characteristics associated with disease course.Methods:The Kaplan-Meier method was used to calculate probabilities of entry into CDC clinical classes A, B, and C (mild, moderate, and severe HIV disease); CDC immunologic stages 2 and 3; and death. Relative risks of progression for selected predictor events were estimated using the Cox proportional hazards model.Results:With a median 24 months of follow-up, the median ages at entry into clinical classes A, B and C were 5, 11, and 48 months, respectively. Increased risk of progression to class C was seen in infants who had: onset of class B events (p<. 001); progression to immunologic stage 2 (p<. 001) or 3 (p<. 001); early culture positivity (in first 48 hours, p<. 01; in first 7 days, p=. 03); and early appearance (within the first 3 months of life) of lymphadenopathy, hepatomegaly, or splenomegaly (p<. 001).Conclusions:Reaching specific clinical or immunologic stages were strong predictors of progression to AIDS or death. Early onset of clinical signs (onset of lymphadenopathy, hepatomegaly, or splenomegaly≤ 3 months of age), and early culture positivity (within the first 48 hours or within the first week of life), defined the infant with highest risk of disease progression.