[The parameters of the immune function in the evolution of HIV-1 infection in institutionalized children in Romania].

Objective: To describe the evolution of HIV-1 + horizontal infected children nursed in closed community.
Method: The biological status of 26 HIV-1 + children nursed in Iaşi Orphanage was assessed in dynamic during April. 1993-Feb. 1994. The income age ranged among 1 month-3 years.
Results: The following progressive stages could be drawn accordingly to the biological status parameters dynamic: stage 1 ("oligosymptomatic"), stage 2 ("multiform, medium or severe symptomatology"), and stage 3 ("severe immunodepression, with predominant infectious symptomatology, waves evolution"). These stages could not be assimilated to the currently CDC or WHO classifications. The following thresholds of the immunologically parameters separate the stages 1 and 2, and respective stages 2 and 3: CD4% lymphocytes (27% respective 20%); absolute CD4+ lymphocytes (1150/microliter respective 700 + 750/microliter), CD4/CD8 ratio (0.75 respective 0.45), beta 2-microglobulin (1.5 mg/1000 respective 2.5 mg/ 1000). Lymphocytes lacking the markers CD4, CD8, CD19, CD3, ranging between 15 + 20% were also detected by flow-cytometry; these cells could be attributed to the immature subpopulations (typically for dystrophy) or to down-regulation of membrane expression of some markers. Also, a dichotomy in the distribution of the CD2/CD3 surface markers was recorded in the case of lymphocytes.
Conclusions: Immunological features demarcate this epidemiological group versus the current described models for the HIV-1 + child.