LOREDANA MANOLESCU*, P. MARINESCU**
*”Carol Davila” University of Medicine and Pharmaceutics, “Ştefan S. Nicolau” Institute of Virology, 285, Mihai Bravu st, Bucharest, 030304, Romania
**Public Health Direction, 82, Bucureşti st, Giurgiu, Romania
Abstract. In resource-limited settings absolute CD4 count is used as an alternative to initiate antiretroviral therapy. Here we assessed sex differences at the last absolute CD4 cell count and progression to AIDS in a cohort of 150 naive HIV-infected children. Absolute CD4 cell count was measured by flow cytometry. Statistical analyses were performed with GraphPad Prism 5.0. In cross-sectional analysis, CD4 count was higher in girls than boys: 161.2±175.7 cells/µL vs 124.1±175.1 cells/µL, with no statistical significant differences, (P = 0.5088). When assessing progression to AIDS, the Kaplan-Meier analysis of the time to progression didn’t demonstrate a significant difference according to sex (P = 0.8842, log-rank test). The eligibility for therapy of boys and girls was equal on the basis of last CD4 count of less than 350 cells/µL. A linear regression model demonstrated that in girls the last CD4 value increased with the time until death while in boys decreased. In conclusion, in AIDS stage there is no signifiant sex-based difference in the CD4 count. CD4 count is a better predictor of mortality in girls. In resource limitted settings treatment guidelines based only on CD4 count, cannot lead to differences in eligibility for antiretroviral treatment according to sex.
Key words: HIV, sex differences, absolute CD4 cell count, progression to AIDS.
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