PEDIATRICS Vol. 107 No. 4 April 2001, p. e56

ELECTRONIC ARTICLE:
The Effect of Plasma Human Immunodeficiency Virus RNA and CD4⁺ T Lymphocytes on Growth Measurements of Hemophilic Boys and Adolescents

Received Aug 21, 2000; accepted Oct 24, 2000.

Margaret W. Hilgartner^*, Sharyne M. Donfield, Henry S. Lynn, W. Keith Hoots^§, Edward D. Gomperts, Eric S. Daar^¶, David Chernoff^#, Sunny K. Pearson, and the Hemophilia Growth and Development Study

From the ^* Division of Pediatric Hematology and Oncology, New York Presbyterian Hospital-Cornell Medical Center, New York, New York;  Rho, Incorporated, Chapel Hill, North Carolina; ^§ Departments of Pediatrics and Internal Medicine, University of Texas Health Science Center, Houston, Texas;  Division of Hematology/Oncology, Childrens Hospital Los Angeles, Los Angeles, California; ^¶ Division of Infectious Diseases, Department of Medicine, Cedars-Sinai Burns and Allen Research Institute, Los Angeles, California; and ^# Chiron Corporation, Emeryville, California.

Objective.  The investigation examined the associations of plasma human immunodeficiency virus (HIV) RNA and CD4⁺ T lymphocytes with height, weight, skeletal maturation, testosterone levels, and height velocity for hemophilic children and adolescents with HIV infection in the Hemophilia Growth and Development Study.

Study Design.  Two hundred seven participants were evaluated over 7 years.

Results.  A threefold increment in baseline plasma HIV RNA was associated with a 0.98-cm decrease in height and a 1.67-kg decrease in weight; 100-cells/µL decrements in baseline CD4⁺ were associated with a 2.51-cm decrease in height and a 3.83-kg decrease in weight. Participants with high plasma HIV RNA (>3125 copies/mL) experienced significant delay in achieving maximum height velocity and lower maximum velocity compared with those with low viral load. The high CD4⁺ (>243)/low plasma HIV RNA group had earlier age at maximum height velocity compared with the other 3 groups and higher maximum height velocity compared with the low CD4⁺/high plasma HIV RNA and low CD4⁺/low plasma HIV RNA groups. Decrements in CD4⁺ were associated with decreases in bone age and testosterone level.

Conclusions.  CD4⁺ and HIV RNA were important in predicting growth outcomes.  Key words:  hemophilia, physical growth, human immunodeficiency virus, immune function, human immunodeficiency virus RNA.

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