Plasma viremia and virus phenotype are correlates of disease progression in vertically human immunodeficiency virus type 1-infected children.
OBJECTIVE
To analyze the relationships among HIV-1 plasma viremia, phenotype and CD4 T cell counts in vertically infected children.


METHODS
Plasma viremia was quantified in 37 vertically infected children at different stages of the disease by a standardized molecular assay. Virus isolation and non-syncytia-inducing or syncytia-inducing (SI) HIV-1 phenotype evaluation were performed in parallel.


RESULTS
HIV-1 RNA genomes were found to be significantly different in CDC clinical classes N, A, B and C (P = 0.0135) and in immunologic classes 1, 2 and 3 (P = 0.0110). None of the children in Class N or A harbored HIV-1 isolates with SI phenotype, whereas SI primary isolates were detected in 2 of 7 (29%) and 7 of 10 (70%) Class B and C children, respectively. Similarly SI variants were present in only 9 of 13 children in immunologic Class 3 (70%). When stratified according to the increasing severity of virologic status, the children showed a significant difference (P = 0.0458) in viral burden.


CONCLUSIONS
Clinical symptoms, the most dramatic being reduction in the number of CD4 lymphocytes, and the highest plasma viremia levels were observed in the children in whom fast replicating, highly cytopathic SI variants were isolated. These data extend the virologic characterization of vertically HIV-1 infected children and suggest that both the plasma viremia levels and phenotype of primary isolates are viral correlates of disease progression in vertically infected children.
Balotta
C
C
Clinica delle Malattie Infettive, University of Milan, Italy. balotta@imiucca.csi.unimi.it
Colombo
M C
MC
Colucci
G
G
Viganò
A
A
Riva
C
C
Papagno
L
L
Violin
M
M
Crupi
L
L
Bricalli
D
D
Salvaggio
A
A
Moroni
M
M
Principi
N
N
Galli
M
M
D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D016655:HIV Core Protein p24 / Q000097:blood; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology* / Q000635:transmission*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D010641:Phenotype; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis; D012194:RNA-Directed DNA Polymerase; D019562:Viral Load; D014766:Viremia / Q000097:blood
D019380:Anti-HIV Agents; D016655:HIV Core Protein p24; D012367:RNA, Viral; D012194:RNA-Directed DNA Polymerase