title: Broad spectrum of time of detection, primary symptoms and disease progression in infants with HIV-1 infection.
abstract: The relationship between time of HIV-1 detection, appearance of symptoms and disease progression was studied in all 24 HIV-1-infected infants from a cohort of 117 children who were born to HIV-1-infected mothers and monitored from birth. HIV isolation from plasma and mononuclear cells, HIV-1 DNA PCR (polymerase chain reaction) and, retrospectively, a quantitative assay for HIV-1 RNA were used for virus detection. Two infants possibly exhibited a symptomatic primary HIV infection. More children with than without symptoms during the first year of life progressed to immunological class 3 (P=0.013) and to AIDS or death (P=0.003) during follow-up. HIV-1 was detected within 4 days of age in 4 of 16 infants: 3 of them became symptomatic within 1 year, as did 6 of the remaining 12 infants (not statistically significant). All four infants in whom virus was detected within 4 days of age progressed to severe immunosuppression, compared to 6 of 14 in whom the virus detection test was initially negative prior to the first positive result (n.s.). Two children with previous repeatedly negative HIV detection tests were diagnosed with HIV-1 infection at 8 and 9 months, respectively. Repeated blood sampling is needed for the diagnosis of HIV-1 infection in perinatally exposed infants, and virus detection tests for exclusion of HIV-1 infection must be used with caution.
authors.affiliation: Department of Pediatrics, Huddinge University Hospital, Stockholm, Sweden. lars.naver@klinvet.ki.se
authors.forename: L
authors.initials: L
authors.lastname: Navér
authors.forename: A
authors.initials: A
authors.lastname: Ehrnst
authors.forename: E
authors.initials: E
authors.lastname: Belfrage
authors.forename: J
authors.initials: J
authors.lastname: Blomberg
authors.forename: B
authors.initials: B
authors.lastname: Christensson
authors.forename: M
authors.initials: M
authors.lastname: Forsgren
authors.forename: G
authors.initials: G
authors.lastname: Lidin-Janson
authors.forename: S
authors.initials: S
authors.lastname: Lindgren
authors.forename: R
authors.initials: R
authors.lastname: Ljung
authors.forename: A
authors.initials: A
authors.lastname: Sönnerborg
authors.forename: A B
authors.initials: AB
authors.lastname: Bohlin
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D013997:Time Factors
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral