Effect of maternal CD4+ cell count, acquired immunodeficiency syndrome, and viral load on disease progression in infants with perinatally acquired human immunodeficiency virus type 1 infection. New York City Perinatal HIV Transmission Collaborative Study Group.
Among a cohort of 152 infants perinatally infected with human immunodeficiency virus type 1, and their mothers, we correlated infant outcome with material CD4+ lymphocyte count and the presence of maternal acquired immunodeficiency syndrome near delivery. In a subset of 50 mother-infant pairs, we also correlated infant outcome with maternal quantitative viral burden as measured by the nucleic acid sequence based amplification system. We found that low maternal CD4+ cell count and high viral burden were associated with decreased time to category C disease or death in infants infected with human immunodeficiency virus type 1. In a multivariate analysis, high maternal viral load and maternal acquired immunodeficiency syndrome were independently associated with shorter time to category C disease or death in infants with human immunodeficiency virus type 1 infection. High viral load in pregnant women, independent of the presence of advanced maternal disease, appears to increase the risk of rapidly progressive disease in their infected offspring.
Lambert
G
G
Department of Pediatrics, Bronx Lebanon Hospital Center, NY 10457, USA.
Thea
D M
DM
Pliner
V
V
Steketee
R W
RW
Abrams
E J
EJ
Matheson
P
P
Thomas
P A
PA
Greenberg
B
B
Brown
T M
TM
Bamji
M
M
Kalish
M L
ML
D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D005260:Female; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007231:Infant, Newborn; D008429:Maternal Welfare; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D012367:RNA, Viral; D019562:Viral Load; D015215:Zidovudine / Q000008:administration & dosage / Q000627:therapeutic use
D000998:Antiviral Agents; D012367:RNA, Viral; D015215:Zidovudine