Human immunodeficiency virus‐1 infection in neonates: correlation of plasma and cellular viremia and clinical outcome

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Abstract:

Among human immunodeficiency virus‐1 (HIV‐1) vertically infected children, two patterns of disease progression have been observed: about 25% develop a severe immunodeficiency within the first 2 years of life; the rest experience a slower progression, like adults. We have assessed infectious viral burden in infected neonates through the French National Prospective Study. Plasma and cell‐associated viremia were assayed by endpoint‐dilution cultures in samples from 46 infants followed prospectively from birth. Plasma and cell‐associated viral burden were found to be significantly higher in rapid progressing infants than in non‐progressing infants in the first months of life: before the age of 2 months, between 2 and 4 months of age and by the age of 6 months. Moreover, among the non‐progressing children, the infectious viral burden before the age of 4 months was predictive of the viral burden measured after the age of 12 months. In conclusion, this work demonstrates that infectious viral load is a reliable predictive marker for rapid progression to AIDS in infants and could be useful for initiating antiretroviral therapy.

Document Type: Original Article

DOI: http://dx.doi.org/10.1111/j.1651-2227.1997.tb18314.x

Affiliations: 1: Laboratoire de Virologie, Hôpital Necker-Enfants Malades, Paris 2: Services de Pédiatrie des Hopitaux de Saint-Denis, Service d'Immuno-Hématologie 3: Aulnay sous Bois, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 4: Lariboisière, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 5: Louis Mourier, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 6: Melun, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 7: Jean Verdier, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 8: Saint-Germain-en-Laye, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 9: Meaux, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 10: Mantes la Jolie, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 11: Longjumeau, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 12: Montfermeil, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 13: INSERM Unité 292, Hôpital du Kremlin-Bicêtre, Kremlin-Bicêtre 14: Service d'Immuno-Hématologie, Hôpital Necker-Enfants Malades, Paris, France

Publication date: June 1, 1997

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