Comparison of HIV type 1 RNA plasma viremia, p24 antigenemia, and unintegrated DNA as viral load markers in pediatric patients.
Better surrogate markers need to be developed to evaluate therapy in HIV-infected children. This study evaluated plasma RNA, immune complex-dissociated p24 antigenemia, and unintegrated DNA (uDNA) in HIV-infected pediatric patients. Ten children were followed from initiation of nucleoside antiretroviral therapy at intervals up to 24 months. Prior to initiation of therapy, HIV RNA was detected in 10 of 10 patients (median, 76,000 Eq/ml), p24 antigen was detected in 8 of 10 patients (median, 193 pg/ml), and uDNA was detected in 6 of 7 patients (median, 10% uDNA). After 12 months the RNA decreased in all patients and became undetectable in six. In contrast, p24 antigenemia decreased in 6 of 10 patients, remained undetectable in 1, and increased in 3. HIV uDNA decreased in six of six patients and became undetectable in three. There was no overall change in CD4 cell count. Plasma RNA and uDNA levels are both sensitive markers of nucleoside therapy in children; however, they do not covary strongly.
Bush
C E
CE
Infectious Disease Research Laboratory, Henry Ford Hospital, Detroit, Michigan 48202, USA.
Donovan
R M
RM
Manzor
O
O
Baxa
D
D
Moore
E
E
Cohen
F
F
Saravolatz
L D
LD
D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D016655:HIV Core Protein p24 / Q000097:blood* / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000235:genetics* / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D008297:Male; D012367:RNA, Viral / Q000097:blood*; D016896:Treatment Outcome; D014766:Viremia; D016662:Virus Integration; D015215:Zidovudine / Q000627:therapeutic use
D015415:Biomarkers; D004279:DNA, Viral; D016655:HIV Core Protein p24; D012367:RNA, Viral; D015215:Zidovudine