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Article

Predictive Value of CD19 Measurements for Bacterial Infections in Children Infected with Human Immunodeficiency Virus

Rebecca A. Betensky, Theresa Calvelli, Savita Pahwa
Rebecca A. Betensky
Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts 02115;
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Theresa Calvelli
Albert Einstein College of Medicine, Bronx, New York; and
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Savita Pahwa
North Shore University Hospital-New York University School of Medicine, Manhasset, New York 11030
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DOI: 10.1128/CDLI.6.2.247-253.1999
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  • Fig. 1.
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    Fig. 1.

    Predictive time to bacterial infection based on baseline Cox model by CD19%.

  • Fig. 2.
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    Fig. 2.

    Predictive time to bacterial infection based on baseline Cox model by IgG level.

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    Fig. 3.

    Predictive time to bacterial infection based on baseline Cox model by CD4 level.

  • Fig. 4.
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    Fig. 4.

    Predictive time to bacterial infection based on landmark Cox model by CD4% 6-month slope and CD4% baseline level. From top to bottom, the CD4% descriptions are as follows: increasing, moderate; increasing, high; stable, high; decreasing, high; stable, moderate; decreasing, moderate; increasing, low; stable, low; and decreasing, low.

Tables

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  • Table 1.

    Normal ranges for IgG and IgA levels and CD19% by age

    Age (mo)IgG level (mg/dl)IgA level (mg/dl)CD19%
    0–1250–1,0005–25
    4–6220–65025–70
    6–12350–1,00025–125
    12–24750–1,05025–175
    24–48500–1,40035–330
    48–96650–1,50035–400
    96–168750–1,65075–500
    >168750–1,77580–550
    2–425–35
    4–824–34
    8–1221–32
    12–3018–28
    >3018–25
  • Table 2.

    Grouping of subjects by CD19%, IgG, and IgA rangea

    RangeTotal no. (%) of subjects
    CD19%IgG (mg/dl)IgA (mg/dl)
    Low592 (47.7)27 (2.2)58 (4.7)
    Normal384 (30.9)147 (11.9)830 (66.9)
    High265 (21.4)1,067 (86.0)353 (28.4)
    • ↵a Based on age-related normal ranges for baseline analysis (1,241 subjects).

  • Table 3.

    Summary statistics for continuous covariatesa

    VariableBaseline analysisLandmark analysis
    MIN33.3%66.7%MAXMedianMIN33.3%66.7%MAXMedian
    Age (mo)2.921.060.0218.437.1321.460.4218.438.2
    CD19%015248019115.5247619
    CD19% slopeNANANANANA−2.5−0.10.13.20.0
    CD4%01626.56621.501727.554.422.3
    CD4% slopeNANANANANA−1.1−0.040.21.90.04
    CD8%235.54886414.535.5478640.8
    CD8% slopeNANANANANA−1.6−0.20.11.5−0.03
    Lym. count20284.41,05812,79245519.63251,59912,640569.3
    Lym. slopeNANANANANA−276−7.10.2292−1.9
    IgG level (mg/dl)611,8102,6308,4502,1801241,8682,7208,1902,230
    IgG slope (mg/dl)NANANANANA−250−171.1207.6−8.4
    IgA level (mg/dl)11132552,72017471162572,720175
    IgA slope (mg/dl)NANANANANA−159.4−1.00.745.1−2.0
    • ↵a The lower (33.3%) and middle (66.7%) tertiles are given. Abbreviations: MIN, minimum; MAX, maximum; Lym., lymphocyte; NA, not available.

  • Table 4.

    Summary statistics for categorical covariates

    CovariateBaseline analysisaLandmark analysisb
    Total (%)No. of infections (%)Total (%)No. of infections (%)
    Male628 (50.6)242 (50.4)355 (51.0)109 (52.2)
    Female613 (49.4)238 (49.6)341 (49.0)100 (47.9)
    Prior ZDV392 (31.6)166 (34.6)132 (19.0)50 (23.9)
    Prior infection520 (41.9)195 (40.6)303 (43.5)61 (29.2)
    Prior IVIG354 (28.5)152 (31.7)170 (24.4)59 (28.2)
    ACTG 051161 (13.0)92 (19.2)81 (11.6)25 (12.0)
    ACTG 128268 (21.6)111 (23.1)197 (28.3)56 (26.8)
    ACTG 13849 (3.9)34 (7.1)17 (2.4)9 (4.3)
    ACTG 14496 (7.7)56 (11.7)51 (7.3)20 (9.6)
    ACTG 152522 (42.1)163 (34.0)346 (49.7)99 (47.4)
    ACTG 190145 (11.7)24 (5.0)4 (0.6)0 (0.0)
    • ↵a A total of 1,241 individuals and 480 infections.

    • ↵b A total of 691 individuals and 209 infections.

  • Table 5.

    Distributions of infection times and follow-up times

    Time interval (mo)Baseline analysisLandmark analysis
    No. of infectionsNo. of off-study subjects without infectionProbability of infection-free outcome (SE)No. of infectionsNo. of off-study subjects without infectionProbability of infection-free outcome (SE)
    0–6203550.836 (0.010)NAaNA
    6–1295870.756 (0.012)70280.899 (0.011)
    12–1866890.693 (0.013)47320.829 (0.014)
    18–2442950.648 (0.014)31730.779 (0.016)
    24–30431370.593 (0.015)331220.717 (0.018)
    30–36181420.561 (0.016)171020.670 (0.020)
    36–4291010.531 (0.018)9910.628 (0.023)
    42–484510.495 (0.024)2370.597 (0.031)
    48–540402
    • ↵a NA, not available.

  • Table 6.

    Hazard of bacterial infection for subjects with high IgG levels and low CD19%a

    IgG level-CD19% combinationPHazard ratioLower limitUpper limit
    Low, low<0.010.50b0.350.73
    Low, moderate0.710.930.631.38
    Low, high0.340.830.561.22
    Moderate, low0.060.700.491.01
    Moderate, moderate0.241.300.842.01
    Moderate, high0.461.160.781.72
    High, moderate0.250.810.561.16
    High, high0.090.720.491.06
    • ↵a Relative to all other IgG level-CD19% combinations in baseline analysis. (In this and subsequent tables, descriptors are given in the same order as the parameters are given atop the first column.) The limits given are 95% confidence intervals.

    • ↵b For example, an individual with a high IgG level and a low CD19% has half the hazard for a bacterial infection of an individual with a low IgG level and a low CD19%.

  • Table 7.

    Hazard of bacterial infection for subjects with high baseline CD19% and increasing CD19%a

    CD19%-CD19% slope combinationPHazard ratioLower limitUpper limit
    Low, decreasing<0.010.300.150.59
    Moderate, decreasing0.020.500.280.91
    High, decreasing<0.010.500.330.74
    Low, stable0.030.520.290.93
    Moderate, stable0.590.860.501.48
    High, stable0.410.850.581.24
    Low, increasing0.020.610.400.93
    Moderate, increasing0.961.010.691.49
    • ↵a Relative to all other CD19%-CD19% slope combinations. See Table 6 for details.

  • Table 8.

    Hazard of bacterial infection for subjects with high baseline IgG levels and increasing IgG levelsa

    IgG level-IgG slope combinationPHazard ratioLower limitUpper limit
    Low, decreasing0.710.880.451.72
    Moderate, decreasing0.571.180.672.07
    High, decreasing0.631.100.741.65
    Low, stable0.990.990.571.75
    Moderate, stable0.251.330.822.17
    High, stable0.231.250.871.79
    Low, increasing0.270.780.531.20
    Moderate, increasing0.721.070.751.52
    • ↵a Relative to all other IgG level-IgG slope combinations. See Table 6 for details.

  • Table 9.

    Hazard of bacterial infection for subjects with increasing CD19% and increasing IgG levelsa

    CD19% slope-IgG slope combinationPHazard ratioLower limitUpper limit
    Decreasing, decreasing0.431.340.652.79
    Decreasing, stable0.521.240.642.41
    Decreasing, increasing0.761.120.542.34
    Stable, decreasing<0.014.652.1110.23
    Stable, stable0.013.591.419.12
    Stable, increasing<0.013.881.679.01
    Increasing, decreasing0.012.721.275.79
    Increasing, stable0.042.511.065.97
    • ↵a Relative to all other CD19% slope-IgG slope combinations. Slopes are categorized according to whether they predict a 30% change from baseline at 6 months.

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Predictive Value of CD19 Measurements for Bacterial Infections in Children Infected with Human Immunodeficiency Virus
Rebecca A. Betensky, Theresa Calvelli, Savita Pahwa
Clinical and Diagnostic Laboratory Immunology Mar 1999, 6 (2) 247-253; DOI: 10.1128/CDLI.6.2.247-253.1999

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Predictive Value of CD19 Measurements for Bacterial Infections in Children Infected with Human Immunodeficiency Virus
Rebecca A. Betensky, Theresa Calvelli, Savita Pahwa
Clinical and Diagnostic Laboratory Immunology Mar 1999, 6 (2) 247-253; DOI: 10.1128/CDLI.6.2.247-253.1999
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