Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

Appendix D: Supplemental Information

Actualizado 11/04/2022 - 12:00 Reviewed Lun, 11/04/2022 - 12:00

Table A. Likelihood of Developing AIDS or Death Within 12 Months, by Age and CD4 T-Cell Percentage or Log₁₀ HIV-1 RNA Copy Number in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy
CD4 Percentage					Log₁₀ HIV RNA Copy Number
Age	10%	20%	25%	30%	6.0	5.0	4.0
Percent Mortality (95% Confidence Interval)
6 Months	28.7	12.4	8.5	6.4	9.7	4.1	2.7
1 Year	19.5	6.8	4.5	3.3	8.8	3.1	1.7
2 Years	11.7	3.1	2.0	1.5	8.2	2.5	1.1
5 Years	4.9	0.9	0.6	0.5	7.8	2.1	0.7
10 Years	2.1	0.3	0.2	0.2	7.7	2.0	0.6
Percent Developing AIDS (95% Confidence Interval)
6 Months	51.4	31.2	24.9	20.5	23.7	13.6	10.9
1 Year	40.5	20.9	15.9	12.8	20.9	10.5	7.8
2 Years	28.6	12.0	8.8	7.2	18.8	8.1	5.3
5 Years	14.7	4.7	3.7	3.1	17.0	6.0	3.2
10 Years	7.4	2.2	1.9	1.8	16.2	5.1	2.2
Note: Table modified from: HIV Paediatric Prognostic Markers Collaborative Study Group. Lancet. 2003;362:1605-1611.

Table B. Death and AIDS/Death Rate per 100 Person-Years by Current Absolute CD4 Cell Count and Age in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy (HIV Paediatric Prognostic Markers Collaborative Study) and Adult Seroconverters (CASCADE Study)
Age (Years)	Absolute CD4 Cell Count (cells/mm³)
Age (Years)	<50	50–99	100–199	200–349	350–499	500+
Rate of Death Per 100 Patient-Years
0–4	59.3	39.6	25.4	11.1	10.0	3.5
5–14	28.9	11.8	4.3	0.89	0.00	0.00
15–24	34.7	6.1	1.1	0.71	0.58	0.65
25–34	47.7	10.8	3.7	1.1	0.38	0.22
35–44	58.8	15.6	4.5	0.92	0.74	0.85
45–54	66.0	18.8	7.7	1.8	1.3	0.86
55+	91.3	21.4	17.6	3.8	2.5	0.91
Rate of AIDS or Death per 100 Patient-Years
0–4	82.4	83.2	57.3	21.4	20.7	14.5
5–14	64.3	19.6	16.0	6.1	4.4	3.5
15–24	61.7	30.2	5.9	2.6	1.8	1.2
25–34	93.2	57.6	19.3	6.1	2.3	1.1
35–44	88.1	58.7	25.5	6.6	4.0	1.9
45–54	129.1	56.2	24.7	7.7	3.1	2.7
55+	157.9	42.5	30.0	10.0	5.1	1.8
Note: Table modified from: HIV Paediatric Prognostic Markers Collaborative Study and the CASCADE Collaboration. J Infect Dis. 2008;197:398-404.

Table C. Association of Baseline Human Immunodeficiency Virus (HIV) RNA Copy Number and CD4 T-Cell Percentage with Long-Term Risk of Death in HIV-Infected Children^a
Baseline HIV RNA^c (Copies/mL) Baseline CD4 Percentage	No. Patients^d	Deaths^b
Baseline HIV RNA^c (Copies/mL) Baseline CD4 Percentage	No. Patients^d	Number	Percentage
≤100,000
≥15%	103	15	(15%)
<15%	24	15	(63%)
>100,000
≥15%	89	32	(36%)
<15%	36	29	(81%)
^a Data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial. ^b Mean follow-up: 5.1 years. ^c Tested by NASBA^® assay (manufactured by Organon Teknika, Durham, North Carolina) on frozen stored serum. ^d Mean age: 3.4 years. Source: Mofenson LM, Korelitz J, Meyer WA, et al. The relationship between serum human immunodeficiency virus type 1 (HIV-1) RNA level, CD4 lymphocyte percent, and long-term mortality risk in HIV-1-infected children. J Infect Dis. 1997;175(5):1029–1038.

Figure A. Estimated Probability of AIDS Within 12 Months by Age and CD4 Percentage in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy — Figure A. Estimated Probability of AIDS Within 12 Months by Age and CD4 Percentage in HIV- Infected Children Receiving No Therapy or Zidovudine Monotherapy

Figure B. Estimated Probability of Death Within 12 Months by Age and CD4 Percentage in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy — Figure B. Estimated Probability of Death Within 12 Months by Age and CD4 Percentage in HIV- Infected Children Receiving No Therapy or Zidovudine Monotherapy

Figure C. Death Rate per 100 Person-Years in HIV-Infected Children Aged 5 Years or Older in the HIV Paediatric Prognostic Marker Collaborative Study and HIV-Infected Seroconverting Adults from the CASCADE Study — Figure C. Death Rate per 100 Person-Years in HIV-Infected Children Aged 5 Years or Older in the HIV Paediatric Prognostic Marker Collaborative Study and HIV-Infected Seroconverting Adults from the CASCADE Study*

Figure D. Estimated Probability of AIDS within 12 Months of Age and HIV RNA Copy Number in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy — Figure D. Estimated Probability of AIDS Within 12 Months of Age and HIV RNA Copy Number in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy

Figure E. Estimated Probability of Death Within 12 Months by Age and HIV RNA Copy Number in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy — Figure E. Estimated Probability of Death Within 12 Months of Age and HIV RNA Copy Number in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy

Figure modified from Lancet 2003;362:1605-1611

Table A. Likelihood of Developing AIDS or Death Within 12 Months, by Age and CD4 T-Cell Percentage or Log₁₀ HIV-1 RNA Copy Number in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy
CD4 Percentage					Log₁₀ HIV RNA Copy Number
Age	10%	20%	25%	30%	6.0	5.0	4.0
Percent Mortality (95% Confidence Interval)
6 Months	28.7	12.4	8.5	6.4	9.7	4.1	2.7
1 Year	19.5	6.8	4.5	3.3	8.8	3.1	1.7
2 Years	11.7	3.1	2.0	1.5	8.2	2.5	1.1
5 Years	4.9	0.9	0.6	0.5	7.8	2.1	0.7
10 Years	2.1	0.3	0.2	0.2	7.7	2.0	0.6
Percent Developing AIDS (95% Confidence Interval)
6 Months	51.4	31.2	24.9	20.5	23.7	13.6	10.9
1 Year	40.5	20.9	15.9	12.8	20.9	10.5	7.8
2 Years	28.6	12.0	8.8	7.2	18.8	8.1	5.3
5 Years	14.7	4.7	3.7	3.1	17.0	6.0	3.2
10 Years	7.4	2.2	1.9	1.8	16.2	5.1	2.2
Note: Table modified from: HIV Paediatric Prognostic Markers Collaborative Study Group. Lancet. 2003;362:1605-1611.

Table B. Death and AIDS/Death Rate per 100 Person-Years by Current Absolute CD4 Cell Count and Age in HIV-Infected Children Receiving No Therapy or Zidovudine Monotherapy (HIV Paediatric Prognostic Markers Collaborative Study) and Adult Seroconverters (CASCADE Study)
Age (Years)	Absolute CD4 Cell Count (cells/mm³)
Age (Years)	<50	50–99	100–199	200–349	350–499	500+
Rate of Death Per 100 Patient-Years
0–4	59.3	39.6	25.4	11.1	10.0	3.5
5–14	28.9	11.8	4.3	0.89	0.00	0.00
15–24	34.7	6.1	1.1	0.71	0.58	0.65
25–34	47.7	10.8	3.7	1.1	0.38	0.22
35–44	58.8	15.6	4.5	0.92	0.74	0.85
45–54	66.0	18.8	7.7	1.8	1.3	0.86
55+	91.3	21.4	17.6	3.8	2.5	0.91
Rate of AIDS or Death per 100 Patient-Years
0–4	82.4	83.2	57.3	21.4	20.7	14.5
5–14	64.3	19.6	16.0	6.1	4.4	3.5
15–24	61.7	30.2	5.9	2.6	1.8	1.2
25–34	93.2	57.6	19.3	6.1	2.3	1.1
35–44	88.1	58.7	25.5	6.6	4.0	1.9
45–54	129.1	56.2	24.7	7.7	3.1	2.7
55+	157.9	42.5	30.0	10.0	5.1	1.8
Note: Table modified from: HIV Paediatric Prognostic Markers Collaborative Study and the CASCADE Collaboration. J Infect Dis. 2008;197:398-404.

Table C. Association of Baseline Human Immunodeficiency Virus (HIV) RNA Copy Number and CD4 T-Cell Percentage with Long-Term Risk of Death in HIV-Infected Children^a
Baseline HIV RNA^c (Copies/mL) Baseline CD4 Percentage	No. Patients^d	Deaths^b
Baseline HIV RNA^c (Copies/mL) Baseline CD4 Percentage	No. Patients^d	Number	Percentage
≤100,000
≥15%	103	15	(15%)
<15%	24	15	(63%)
>100,000
≥15%	89	32	(36%)
<15%	36	29	(81%)
^a Data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Intravenous Immunoglobulin Clinical Trial. ^b Mean follow-up: 5.1 years. ^c Tested by NASBA^® assay (manufactured by Organon Teknika, Durham, North Carolina) on frozen stored serum. ^d Mean age: 3.4 years. Source: Mofenson LM, Korelitz J, Meyer WA, et al. The relationship between serum human immunodeficiency virus type 1 (HIV-1) RNA level, CD4 lymphocyte percent, and long-term mortality risk in HIV-1-infected children. J Infect Dis. 1997;175(5):1029–1038.

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