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Lymphocyte subset changes between 3 and 15 months of age in infants born to HIV‐seropositive women in South Africa

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The evolution of T‐lymphocyte subsets during infancy in perinatally HIV‐infected African babies has not been previously described. In a hospital‐based cohort study, T‐lymphocyte subset changes were investigated in 72 South African black children born to HIV seropositive mothers. Sixteen (22.2%) children were classified as infected and 56 (77.8%) as uninfected by 18 months of age. Four (25%) of the infected infants died before the age of 9 months from HIV‐related disease.

The CD4 and CD8 T‐lymphocyte subsets, expressed in absolute numbers, as percentages, percentiles or as ratios, were clear indicators of HIV infection at all ages between 3 and 15 months. The most marked changes were a decreased percentage of CD4 cells and an increase in percentage of CD8 cells in the infected group. In the 4 infected infants who died, CD8 count and CD4:CD8 ratio clearly predicted poor clinical outcome at 3 months. Taken together, both CD4:CD8 ratio and CD4 percentage are reliable markers of HIV infection in an African paediatric population; however, a raised CD8 lymphocyte count rather than a CD4 count is a more specific prognostic marker of disease progression in HIV infected children.
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Keywords: T‐lymphocyte subsets; diagnostic and prognostic markers; perinatal HIV infection

Document Type: Original Article

Affiliations: 1: Department of Paediatrics and Child Health, University of Natal, Durban, South Africa, 2: Department of Haematology, University of Natal, Durban, South Africa, 3: MRC Centre for Epidemiological Research, Medical Research Council, Durban, South Africa

Publication date: May 1, 1997

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