Faculty Collaboration Database

Human immunodeficiency virus-related conditions in children and adults with hemophilia: rates, relationship to CD4 counts, and predictive value. Blood 1993 Feb 01;81(3):828-34

Date

02/01/1993

Pubmed ID

8427974

Scopus ID

2-s2.0-0027525934 (requires institutional sign-in at Scopus site)   40 Citations

Abstract

To further elucidate the natural history of human immunodeficiency virus (HIV) infection, we studied intermediate HIV-related conditions occurring before acquired immunodeficiency syndrome (AIDS) in a prospectively observed multicenter cohort of 738 HIV-infected persons with hemophilia. We analyzed the frequency in adults and children of common HIV-related conditions and the relative risk of AIDS after occurrence of these conditions, controlling for age at seroconversion and the percentage of CD4+ lymphocytes. Thrombocytopenia was the most frequently observed condition with cumulative incidences of 43% +/- 7% in adults and 27% +/- 6% in children and adolescents by 10 years after seroconversion. Oral candidiasis, fever, weight loss, and non-AIDS pneumonia were two to four times more common in adults than children, whereas herpes zoster risk was similar in the two age groups. HIV-related conditions were infrequent during the first 4 years of infection, particularly in children. With the exception of thrombocytopenia, mean CD4 counts were less than 350 cells/microL at the onset of the conditions. The relative hazard of AIDS after oral candidiasis was 18 in children and 3.8 in adults. Relative hazard in adults was also increased after persistent fever (10), weight loss (3.2), and non-AIDS pneumonia (2.2). Herpes zoster and thrombocytopenia were not significantly associated with AIDS in either age group. We conclude that intermediate HIV-related conditions occur more frequently in adults than in children with hemophilia. Persistent fever is the strongest predictor of AIDS in adults, whereas oral candidiasis is the strongest predictor in children. These findings should facilitate the design and conduct of clinical trials as well as the management of HIV-infected children and adults.

Author List

Eyster ME, Rabkin CS, Hilgartner MW, Aledort LM, Ragni MV, Sprandio J, White GC, Eichinger S, de Moerloose P, Andes WA

Author

Gilbert C. White MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acquired Immunodeficiency Syndrome
Adult
Age Factors
CD4 Antigens
Candidiasis
Candidiasis, Oral
Child
Cohort Studies
Fever
Follow-Up Studies
HIV Infections
HIV Seropositivity
Hemophilia A
Herpes Zoster
Humans
Incidence
Pneumonia
Prospective Studies
Risk Factors
Thrombocytopenia
Time Factors
Weight Loss