       Document 0488
 DOCN  M9460488
 TI    CD4 T cell count as predictor of Pneumocystis carinii pneumonia in
       children born to mothers infected with HIV. European Collaborative Study
       Group [see comments]
 DT    9404
 SO    BMJ. 1994 Feb 12;308(6926):437-40. Unique Identifier : AIDSLINE
       MED/94169773
 CM    Comment in: BMJ 1994 Feb 12;308(6926):425-6
 AB    OBJECTIVE--To assess the value of CD4 T cell count in predicting
       Pneumocystis carinii pneumonia in infants born to mothers infected with
       HIV, with reference to the guidelines from the Centers for Disease
       Control on prophylaxis against pneumocystis. DESIGN--Prospective birth
       cohort study. SETTING--Hospitals in 10 European cities participating in
       the European collaborative study. SUBJECTS--924 children born to mothers
       known to be infected with HIV at or before delivery. MAIN OUTCOME
       MEASURES--The incidence of P carinii pneumonia. CD4 T cell counts in
       children before diagnosis of the pneumonia. The proportions of children
       infected and uninfected with HIV who fulfilled the criteria for primary
       prophylaxis. RESULTS--Fourteen children were diagnosed with P carinii
       pneumonia. The cumulative incidence by the age of 6 years was 2% (95%
       confidence interval 0.9 to 3.0%). Of the 11 children with a CD4 T cell
       count predating diagnosis, only three fulfilled the criteria from the
       Centers for Disease Control for prophylaxis. Prophylaxis was indicated
       by 1 year of age for 62% of infected children who had not developed P
       carinii pneumonia and for at least 10% of uninfected children.
       CONCLUSIONS--Monitoring CD4 T cell count seems to be of limited value in
       deciding when to start prophylaxis against P carinii pneumonia in
       children born to mothers infected with HIV. The alternative approach of
       giving prophylaxis to all children born to infected mothers would be
       difficult to justify given the low incidence of the pneumonia.
 DE    Age Factors  AIDS-Related Opportunistic Infections/*BLOOD/EPIDEMIOLOGY
       Child  Child, Preschool  Cohort Studies  Human  HIV
       Infections/*BLOOD/EPIDEMIOLOGY  Incidence  Infant  *Leukocyte Count
       Pneumonia, Pneumocystis carinii/*BLOOD/DIAGNOSIS/EPIDEMIOLOGY/
       PREVENTION & CONTROL  Prospective Studies  Support, Non-U.S. Gov't  *T4
       Lymphocytes  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

