Document 0601
 DOCN  M95A0601
 TI    Analysis of early viral load in infants with perinatally-acquired HIV.
       American Pediatric Society 104th annual meeting and Society for
       Pediatric Research 63rd annual meeting; 1994 May 2-5; Seattle.
 DT    9510
 AU    Palumbo PE; Kwok S; Waters S; Wesley Y; McKinney N; Oleske JM; Connor
       EM; Dept. of Pediatrics, UMD-New Jersey Medical School, Newark, USA.
 SO    Pediatr AIDS HIV Infect. 1994 Oct;5(5):322 (unnumbered abstract). Unique
       Identifier : AIDSLINE AIDS/95330443
 AB    The dynamics of HIV infection early in perinatally infected infants is
       poorly understood. Serial plasma and mononuclear cell (MNC) samples from
       8 HIV-infected infants were assayed by quantitative RNA PCR for free
       virus and by quantitative DNA PCR for infected cells. Virus was
       detectable by RNA PCR in 6/8 infants in the first 11 days of life, with
       a mean among positives of 9.9 +/- 8.7 x 10(5) viral particles/ml plasma.
       For 5 of the 6 newborns, quantities of virus were very high (> or = 2.5
       x 10(5)). Similarly, the HIV provirus was detected in 4/7 MNC samples
       with a mean among positives of 89 copies per 1 x 10(5) MNCs assayed
       (range, 53 to 115). Serial studies over a 3-12 month period revealed a
       persistent high viral load in 6 of 8 infants studied, with 9.3 +/- 8.7 x
       10(5) virus particles per ml plasma (n = 28) and 215 +/- 313 HIV copies
       per 1 x 10(5) MNCs (n = 29). All but one infant had age-appropriate CD4
       lymphocyte counts through 4 months of age and 5/8 through 6 months.
       Similarly, 50% had no HIV-associated signs or symptoms until 6 months of
       age, while those with early symptoms exhibited only organomegaly or
       lymphadenopathy. In conclusion, high viral loads were detected early in
       perinatal infection and usually persisted for months, even in
       conjunction with normal immune cell numbers and clinical course. As
       opposed to adults, persistence of substantial viremia levels suggests an
       ineffective immune response and the need to evaluate early
       antiretroviral therapy in perinatal HIV infection.
 DE    CD4 Lymphocyte Count  *Disease Transmission, Vertical  DNA,
       Viral/ANALYSIS  Human  HIV/*ISOLATION & PURIF  HIV
       Infections/IMMUNOLOGY/TRANSMISSION/*VIROLOGY  Infant  Infant, Newborn
       RNA, Viral/ANALYSIS  Viremia  MEETING ABSTRACT  JOURNAL ARTICLE

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