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Total Lymphocytes Predict HIV Progression in Children

A simple way to assess need for antiretroviral therapy in developing countries

THURSDAY, Dec. 1 (HealthDay News) -- Total lymphocyte count is only slightly less powerful than CD4 cell count as a predictor of disease progression in HIV-infected children, and could be an easier way to gauge the need for antiretroviral therapy in resource-poor nations, researchers reported in the Nov. 26 issue of The Lancet.

David Dunn, M.D., of the Medical Research Council Clinical Trials Unit in London, and colleagues conducted a meta-analysis of longitudinal data on 3,917 children infected with HIV. They calculated the 12-month risk of death and progression to AIDS using total lymphocyte count and age. These figures were compared with risk of disease progression before the initiation of antiretroviral therapy or during zidovudine monotherapy.

When the total lymphocyte count was less than 1500-2000 cells/microliter, it was a strong predictor of AIDS and mortality risk in children over age two. In younger children, total lymphocyte count was less prognostic.

Even an imperfect addition to clinical assessment will likely result in improved outcome in children and adults infected with HIV, particularly in areas with limited resources, such as developing countries, according to an editorial by David Moore, MDCM, and Julio Montaner, M.D., of the British Columbia Centre for Excellence in HIV/AIDS in Vancouver.

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