Long-term pattern of HIV-1 RNA load in perinatally infected children.
The objective of this study was to describe the natural history of HIV-1 RNA load in vertically HIV-1-infected children. HIV-1 RNA in 156 plasma or serum samples (1-14, median 4 from each child) from 32 vertically HIV-1-infected children was detected with the NASBA technique (Organon Teknika, The Netherlands). Twenty-one children were prospectively followed from birth, and 11 were identified and included at the age of 7-89 (median 61) months. The highest numbers of HIV-1 RNA copies were seen at 1.5-3 months of age. A quadratic curve model showed a reduction of HIV-1 RNA with increasing age up to approximately 8 years, and thereafter increasing numbers, p(age) = 0.002, p(age2) = 0.008. This pattern was not typical for individual children in whom a great variation in HIV-1 RNA numbers was seen over time. The interval from birth to the first HIV-1 RNA peak ranged from 1.5 months to more than 2 years. The HIV-1 RNA levels remained relatively high and fluctuating over the years in symptomatic as well as in long-term asymptomatic children. This makes HIV-1 RNA determination in children more difficult to use than in adults, as the only tool for prediction of disease progression and for initiation of therapy.
Navér
L
L
Department of Paediatrics, Huddinge University Hospital, Sweden.
Ehrnst
A
A
Belfrage
E
E
Sönnerborg
A
A
Lidin-Janson
G
G
Christensson
B
B
Ljung
R
R
Bohlin
A B
AB
D018791:CD4 Lymphocyte Count; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology / Q000635:transmission* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013548:Sweden; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy / Q000276:immunology / Q000635:transmission* / Q000821:virology*; D015215:Zidovudine / Q000627:therapeutic use
D012367:RNA, Viral; D015215:Zidovudine