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December 1991

A Third Pattern of Disease Progression in Children Infected With Human Immunodeficiency Virus-Reply

Author Affiliations

Pediatric Immunology Division, INSERM U 132, and Virology Unit Hopital Necker 149 rue de Sèvres 75015 Paris, France MARC TARDIEU, MD Pediatric Neurology Division, INSERM U 56
Epidemiology Division, INSERM U 292 Bicêtre Hospital Paris, France

Am J Dis Child. 1991;145(12):1349. doi:10.1001/archpedi.1991.02160120016007

In Reply.—We fully agree with the comments by Drs Katz and McNamara regarding the various types of disease progressions in children infected with (HIV). Indeed, some patients with a "borderline" or an unusual progression might not perfectly fit into our description of a "bimodal population" of children according to the progression of the disease.1 We followed up a child, perinatally infected with HIV, who, at age 4 months, developed Pneumocystis carinii pneumonia. Three years later she was well, with no neurologic impairment or secondary infection. Her most recent CD4 cell count was over 1.5× 109/L, and the results of her in vitro lymphocyte proliferation tests became progressively normal, showing an association between the clinical and immunologic improvements. In most cases of HIV-infected children, there is a correlation between the severity of the symptoms and the impairment of the immune system or the intensity of the viral load. However,

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