5 5 Asthma Phenotypes at Age 4: Follow-up of Disadvantaged Wheezing Infants M. D. Klinnert l, M. R. Price 2, A. H. Liu I, C. A. Dennisl; ]Pediatrics, National Jewish Medical and Research Center, Denver, CO, 2pediatrics, National Jewish Medical and Research Center, Denver, CO. RATIONALE: Despite epidemiological evidence indicating an increase in asthma morbidity among low income minority children less than age 5 years, little is known regarding the natural history and phenotypic distribution of asthma in this group. METHODS: The Childhood Asthma Prevention Study recruited lowincome families of children age 9-24 months with >3 wheezing episodes. Home and laboratory assessments were conducted, and half of the families were randomized to environmental support lasting one year. At age 4 years the children were evaluated using prick skin testing, pulmonary functions, and medical record review, and caregiver symptom reports (modified ATS-B questionnaire assessing 5 symptoms) for the previous 12 months. We report here illness patterns for children (n=124) with complete 4-year evaluations, regardless of intervention assignment. RESULTS: Caregivers reported wheezing between 3 and 4 years for 85% of children. 58% were positive for 3/5 ATS-B questions, and 38% for 4/5 questions. 34% of the children had >1 positive skin test (atopic). Children meeting ATS-B criteria for asthma were no more likely to be atopic than those not (3/5 p=0.32; 4/5 p=0.60). Among the children meeting either criteria level, atopic children were significantly more likely to have had a corticosteroid burst (p<0.04) or hospitalization (p<0.005). However, atopic and nonatopic children were equally likely to utilize the ED for wheezing illness. CONCLUSIONS: Most disadvantaged children with frequent wheezing as infants showed significant morbidity at age 4 years, with continued wheezing and frequent ED visits. Those with both wheezing and atopy showed a pattern of more severe illness. Funding: N1H/NIAID