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Estimating risk of disease progression in HIV-infected children  

The HIV Paediatric Prognostic Markers Collaborative Study (HPPMCS) is a collaboration between investigators of European and US cohort studies and randomised trials of perinatally HIV-1 infected children. By pooling longitudinal data on around 4000 children with follow-up before they received effective antiretroviral therapy, the collaboration has yielded valuable insights into the use of laboratory markers to predict natural disease progression.

In particular, we have derived estimates of the 12-month risks of progression to AIDS and to death for CD4 percent, CD4 count, total lymphocye count, and viral load. These estimates may be helpful for deciding when to start antiretroviral therapy or when to re-start treatment after an interruption. A risk calculator is provided to obtain these estimates.

World Health Organisation guidelines on when to initiate therapy in resource-limited settings (http://www.who.int/hiv/pub/guidelines/arv/en/index.html) are partly based on these data.

Details of the participating studies and the analytical methods can be found in the study publications.

If you have any comments on these web pages please contact David Dunn (dtd@ctu.mrc.ac.uk).