Tumor necrosis factor-α in pediatric HIV-1 infection

Objective: To evaluate the diagnostic and prognostic value of serum tumor necrosis factor-α (TNF-α) levels in HIV-1-infected children. Design: Serum levels of TNF-α were evaluated in 57 HIV-1-infected symptomatic children aged between 7 months and 8 years. Methods: TNF-α levels were determined by enzyme immunoassay. The sensitivity of the assay was 10 pg/ml. Results: TNF-α levels (mean ± s.d.) were significantly elevated in HIV-1-infected patients (285 ± 390 pg/ml), compared with HIV-1-uninfected age-matched controls (22.7 ± 4.9 pg/ml). Among HIV-1-infected children the highest levels of TNF-α were noted in those with Mycobacterium avium intracellulare (MAI) infection and those with interstitial lymphoid pneumonitis (LIP). In contrast, patients with Pneumocystis carinii pneumonia, progressive encephalopathy or cachexia did not have markedly elevated TNF-α levels. Conclusions: Serum TNF-α is increased in symptomatic HIV-1-infected children, with higher levels in children with LIP or MAI. Serum TNF-α levels are not diagnostic for cachexia or progressive encephalopathy.