Published online July 3, 2006
PEDIATRICS Vol. 118 No. 1 July 2006, pp. 146-155 (doi:10.1542/peds.2005-0294)
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Human Immunodeficiency Virus...

Gender Differences in Lymphocyte Populations, Plasma HIV RNA Levels, and Disease Progression in a Cohort of Children Born to Women Infected With HIV

Marc Foca, MDa, Jack Moye, MDb, Clara Chu, PhDc, Yvonne Matthewsc, Ken Rich, MDd, Ed Handelsman, MDe, Katherine Luzuriaga, MDf, Mary Paul, MDg, Clemente Diaz, MDh Women and Infants Transmission Study

a Department of Pediatrics, Columbia University, New York, New York
b National Institute of Child Health and Human Development, Bethesda, Maryland
c Clinical Trials and Surveys Corp, Baltimore, Maryland
d Department of Pediatrics, University of Illinois, Chicago, Illinois
e Department of Pediatrics, State University of New York, Brooklyn, New York
f Department of Pediatrics, University of Massachusetts, Worcester, Massachusetts
g Department of Pediatrics, Baylor University College of Medicine, Houston, Texas
h Department of Pediatrics, University of Puerto Rico, San Juan, Puerto Rico

OBJECTIVE. We sought to document gender differences in lymphocyte subsets and plasma RNA levels in a pediatric cohort with presumed minimal hormonal differences (on the basis of age).

METHODS. Blood samples from antiretroviral therapy-treated, HIV-infected children (n = 158) and HIV-uninfected children (n = 1801) who were enrolled in the Women and Infants Transmission Study were analyzed at specified study intervals with consensus protocols, and various parameters were compared.

RESULTS. Antiretroviral therapy-treated, HIV-infected female children had, on average, 0.38 log10 copies per mL lower plasma RNA levels than did their male counterparts, but lymphocyte differences were not noted in this cohort. Despite their higher plasma RNA level, a greater proportion of male children survived through 8 years of age. There were no gender differences with respect to the age of diagnosis of HIV, time to antiretroviral therapy after diagnosis of HIV, or type of antiretroviral therapy. Lymphocyte differences were noted for uninfected children.

CONCLUSIONS. Plasma RNA levels differed among antiretroviral therapy-treated, HIV-infected children according to gender, in a manner similar to that noted in previous pediatric and adult studies. Lymphocyte subsets varied according to gender in a cohort of HIV-exposed but uninfected children. Most importantly, overall mortality rates for this cohort differed according to gender.

Key Words: HIV • gender

Abbreviations: WITS—Women and Infants Transmission Study • ECS—European Collaborative Study • CDC—Centers for Disease Control and Prevention • ART—antiretroviral therapy • REACH—Reaching for Excellence in Adolescent Care and Health

Accepted Jan 19, 2006.