Predictive value of CD19 measurements for bacterial infections in children infected with human immunodeficiency virus

Rebecca Betensky, Theresa Calvelli, Savita Pahwa

Research output: Contribution to journalArticle

Abstract

We investigated the predictive value of CD19 cell percentages (CD19%) for times to bacterial infections, using data from six pediatric AIDS Clinical Trials Group protocols and adjusting for other potentially prognostic variables, such as CD4%, CD8%, immunoglobulin (IgA) level, lymphocyte count, prior infections, prior zidovudine treatment, and age. In addition, we explored the combined effects of CD19% and IgG level in predicting time to infection. We found that a low CD19% is associated with a nonsignificant 1.2-fold increase in hazard of bacterial infection (95% confidence interval: 0.97, 1.49). In contrast, a high IgG level is associated with a nonsignificant 0.87-fold decrease in hazard of infection (95% confidence interval: 0.68, 1.12). CD4% was more prognostic of time to bacterial infection than CD19% or IgG level. Low CD19% and high IgG levels together lead to a significant (P < 0.01) 0.50-fold decrease in hazard (95% confidence interval: 0.35, 0.73) relative to low CD19% and low IgG levels. Similarly, in a model involving assay result changes (from baseline to 6 months) as well as baseline values, the effect of CD19% by itself is reversed from its effect in conjunction with IgG. In this model, CD19% that are increasing and high are associated with decreases in hazard of infection (P < 0.01), while increasing CD19% and increasing IgG levels are associated with significant (at the P = 0.01 level) fourfold increases in hazard of infection relative to stable CD19% and decreasing; stable, or increasing IgG levels. Our data suggest that CD19%, in conjunction with IgG level, provides a useful prognostic tool for bacterial infections. It is highly likely thai T-helper function impacts on B-cell function; thus, inclusion of CD4% in such analyses may greatly enhance the assessment of risk for bacterial infection.

Original languageEnglish (US)
Pages (from-to)247-253
Number of pages7
JournalClinical and Diagnostic Laboratory Immunology
Volume6
Issue number2
StatePublished - Mar 1 1999

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Viruses
Bacterial Infections
Immunoglobulin G
HIV
Hazards
Infection
Confidence Intervals
Pediatrics
Lymphocytes
Zidovudine
Lymphocyte Count
Clinical Protocols
Immunoglobulin A
Immunoglobulins
Assays
Acquired Immunodeficiency Syndrome
B-Lymphocytes
Cells
Clinical Trials

ASJC Scopus subject areas

  • Microbiology (medical)
  • Immunology and Allergy
  • Clinical Biochemistry
  • Immunology

Cite this

Predictive value of CD19 measurements for bacterial infections in children infected with human immunodeficiency virus. / Betensky, Rebecca; Calvelli, Theresa; Pahwa, Savita.

In: Clinical and Diagnostic Laboratory Immunology, Vol. 6, No. 2, 01.03.1999, p. 247-253.

Research output: Contribution to journalArticle

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abstract = "We investigated the predictive value of CD19 cell percentages (CD19{\%}) for times to bacterial infections, using data from six pediatric AIDS Clinical Trials Group protocols and adjusting for other potentially prognostic variables, such as CD4{\%}, CD8{\%}, immunoglobulin (IgA) level, lymphocyte count, prior infections, prior zidovudine treatment, and age. In addition, we explored the combined effects of CD19{\%} and IgG level in predicting time to infection. We found that a low CD19{\%} is associated with a nonsignificant 1.2-fold increase in hazard of bacterial infection (95{\%} confidence interval: 0.97, 1.49). In contrast, a high IgG level is associated with a nonsignificant 0.87-fold decrease in hazard of infection (95{\%} confidence interval: 0.68, 1.12). CD4{\%} was more prognostic of time to bacterial infection than CD19{\%} or IgG level. Low CD19{\%} and high IgG levels together lead to a significant (P < 0.01) 0.50-fold decrease in hazard (95{\%} confidence interval: 0.35, 0.73) relative to low CD19{\%} and low IgG levels. Similarly, in a model involving assay result changes (from baseline to 6 months) as well as baseline values, the effect of CD19{\%} by itself is reversed from its effect in conjunction with IgG. In this model, CD19{\%} that are increasing and high are associated with decreases in hazard of infection (P < 0.01), while increasing CD19{\%} and increasing IgG levels are associated with significant (at the P = 0.01 level) fourfold increases in hazard of infection relative to stable CD19{\%} and decreasing; stable, or increasing IgG levels. Our data suggest that CD19{\%}, in conjunction with IgG level, provides a useful prognostic tool for bacterial infections. It is highly likely thai T-helper function impacts on B-cell function; thus, inclusion of CD4{\%} in such analyses may greatly enhance the assessment of risk for bacterial infection.",
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