2nd National Conference Human Retroviruses and Related Infections Washington, DC - January 29 - February 2, 1995

Natl Conf Hum Retrovir Relat Infect 1995 Jan 29-Feb 2;2: (abstract no. 21)

Dickover R, Kwok S, Christopherson C, Wei L, and Bryson Y
UCLA School of Medicine, Los Angeles, CA; Roche Molecular Systems, Alameda, CA

Vertically acquired HIV infection is characterized by bimodal onset of symptoms and disease progression with rapid progression seen in approximately 1/3 of infected infants. Both the timing of transmission and pattern of HIV replication soon after delivery appear to be important determinants of outcome. We performed quantitative PCR (RNA and DNA) on serial samples from birth in infants at risk for vertical HIV infection and correlated our results with HIV coculture ICD p24, CD4 count and infant outcome. RNA PCR (Roche) confirmed the absence of HIV viremia at birth in 6 infants defined as intrapartum infected based on negative DNA PCRs and cocultures at birth (O RNA copies/ml). In contrast all 12 in utero infected infants were positive for HIV RNA and DNA at birth (x=190,013 RNA copies/ml). Seven infants with rapid on set of symptoms and loss of CD4 cells showed a burst of HIV replication after birth (x peak=2,619,726 RNA copies/ml [860,000 - >3 million range]). Four infants who maintained relatively normal CD4 counts had a slow onset of symptoms and disease progression and a lower virus load (x peak = 1,120,145 RNA copies/ml; p=0.01 [480,000-1.7 million range]). Our results indicate that rapid HIV replication early in vertical infection is associated with rapid disease progression. RNA PCR may prove useful for identifying infants who should be targeted for early antiretroviral therapy prior to the loss of CD4 cells.

Keywords: AIDS Vaccines, Acquired Immunodeficiency Syndrome, Anti-HIV Agents, CD4 Lymphocyte Count, Disease Progression, HIV, HIV Core Protein p24, HIV Infections, HIV Seropositivity, Humans, Infant, Polymerase Chain Reaction, Viremia, immunology

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1995-01-29
21

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