AEGiS-14IAC: HIV-1 subtype C infected children who have survived beyond five years of age have high levels of neutralizing antibodies.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

HIV-1 subtype C infected children who have survived beyond five years of age have high levels of neutralizing antibodies.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10209)

Taylor NA, Morris L, Meyers TM
National Institute for Communicable Diseases, Johannesburg, South Africa

BACKGROUND: Perinatal HIV-1 infection remains a major route of transmission in developing countries with few children surviving beyond five years of age. Neutralizing antibodies (NAb) are considered an important immune control mechanism and in this study we aimed to examine levels of NAb in children who have survived beyond five years with HIV-1.

METHODS: Serum from 41 HIV-1 infected children with slow progressing disease were used to measure NAb levels and compared to clinical, virological and immunological parameters. All children were outpatients at a pediatric AIDS Clinic at the Chris Hani Baragwanath Hospital in Soweto, Johannesburg. All children were infected perinatally and majority were 5 years or older (median age 6.1, range 4-11). Three children were asymptomatic (N), 7 had mild disease (A), 26 had moderate disease (B) and 3 had severe disease (C). Sera were assayed against a heterologous primary subtype C virus, Du151, using a PBMC-based neutralization assay with a p24 antigen read-out.

RESULTS: Forty of the 41 infected children had measurable neutralization titers (80% inhibitory dose). Twelve had low titers (between 1:4 and 1:12), 13 had moderately high titers (1:12-1:36), 28 had high titers (1:36-1:108) and 8 had extremely high titers (>1:108). The median viral load (VL) for the group was 100,933 copies/ml (<50-359,060) and the median CD4 count was 528 cells/micro-l (7-2,300). There was no correlation between neutralization titers and CD4 count, VL, age or clinical status. Follow-up samples from 17 children showed that that these titers were maintained over 1-2 years.

CONCLUSIONS: High levels of neutralizing antibodies are seen with slow disease progression amongst this cohort of HIV-1 infected children.

Keywords: AEGIS, HIV-1, CD4 Lymphocyte Count, Viral Load, Disease Progression, Acquired Immunodeficiency Syndrome, Skin Tests, Child, Human

020707
B10209