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Leslie A. Kalish, Kenneth McIntosh, Jennifer S. Read, Clemente Diaz, Sheldon H. Landesman, Jane Pitt, Kenneth C. Rich, William T. Shearer, Katherine Davenny, Judy F. Lew, for the Women and Infants Transmission Study, Evaluation of Human Immunodeficiency Virus (HIV) Type 1 Load, CD4 T Cell Level, and Clinical Class as Time-Fixed and Time-Varying Markers of Disease Progression in HIV-1—Infected Children, The Journal of Infectious Diseases, Volume 180, Issue 5, November 1999, Pages 1514–1520, https://doi.org/10.1086/315064
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Abstract
Human immunodeficiency virus (HIV) type 1 RNA load, CD4 T cell level, and Centers for Disease Control and Prevention (CDC) clinical class history were measured as potential correlates of a CDC class C diagnosis or death in 165 HIV-1—infected children followed from birth. These covariates were assessed at fixed “landmark” ages from 6 to 24 months and were also assessed as time-varying values. Virus load was associated with progression in all analyses, even after adjusting for immunologic and clinical status. This confirms its importance for monitoring pediatric disease progression. CD4 T cell level was associated with disease progression in time-varying but not in adjusted landmark analysis, suggesting that CD4 cells reflects immediate risk more than long-term risk. The distinction between clinical class B and lower classes is prognostic during the first 18 months of life; class C versus classes N/A/B becomes more important as the patient ages. Virologic, immunologic, and clinical status all provide information regarding disease progression risk.