Virus levels in untreated African infants infected with human immunodeficiency virus type 1.
In developed areas, human immunodeficiency virus (HIV)-infected infants have high virus levels and rapidly progress to death. HIV levels were assessed in 1994-1997 in untreated infants in Malawi by analysis of dried blood spots tested by nucleic acid silica-bound amplification. Of 24 umbilical cord blood (CB)-positive samples, 83% had >10,000 copies/mL. The median virus level was 78,000 copies/mL. First positive sample median levels were 355,000 copies/mL among 52 perinatally infected infants and 130,000 copies/mL among 43 infants infected by breast-feeding. Virus levels were stable, and initial levels predicted levels 1 year after infection (P=.005), at which time levels did not significantly differ among in utero, perinatally, or postnatally infected infants. Thus, neither age at infection nor route of infection significantly influenced HIV levels measured 1 year after infection. Most (87%) CB-positive infants were infected before labor onset, since virus levels greatly exceeded those expected in their mothers.
Biggar
R J
RJ
Viral Epidemiology Branch, National Cancer Institute, National Institute of Allergy and Infectious Diseases, Rockville, MD 20862, USA. biggarb@epndce.nci.nih.gov
Janes
M
M
Pilon
R
R
Miotti
P
P
Taha
T E
TE
Broadhead
R
R
Mtimivalye
L
L
Kumwenda
N
N
Cassol
S
S
D000328:Adult; D001800:Blood Specimen Collection; D001942:Breast Feeding; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005312:Fetal Blood / Q000821:virology*; D015658:HIV Infections / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008295:Malawi; D021141:Nucleic Acid Amplification Techniques; D016133:Polymerase Chain Reaction / Q000379:methods; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D012367:RNA, Viral / Q000097:blood*; D012680:Sensitivity and Specificity; D019562:Viral Load
D004279:DNA, Viral; D012367:RNA, Viral