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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
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Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays

Published on: September 26, 2011

Pediatric HIV-1 in Kenya: pattern and correlates of viral load and association with mortality

Elizabeth Maleche Obimbo1, Dalton Wamalwa, Barbara Richardson

  • 1Department of Pediatrics, University of Nairobi, Nairobi, Kenya.

Journal of Acquired Immune Deficiency Syndromes (1999)
|June 9, 2009
PubMed

Insights

Infants infected with HIV-1 after one month of age had better viral control. Maternal viral load predicted infant viral load, which is linked to early mortality in children.

Area of Science:

  • Pediatric infectious diseases
  • Virology
  • Immunology

Background:

  • Limited data exists on viral replication patterns in vertically HIV-1-infected children in resource-limited settings.
  • Understanding these patterns is crucial for improving outcomes.

Purpose of the Study:

  • To investigate the pattern and correlates of human immunodeficiency virus type 1 (HIV-1) replication in vertically infected children.
  • To determine the role of viral replication on child outcomes up to 24 months of age.

Main Methods:

  • Longitudinal follow-up of 85 HIV-1-infected infants from birth to 24 months.
  • Comparison of serial HIV-1 RNA levels based on timing of infection (in utero, peripartum, late postnatal).
  • Determination of cofactors for viral peak, set point, and mortality.

Main Results:

  • Infants infected after 1 month had significantly lower HIV-1 viral load set points compared to those infected earlier (P = 0.01).
  • Maternal viral load strongly correlated with peak infant viral load (P < 0.001).
  • Low CD4% at 6 months (<15%) independently predicted mortality (HR = 4.85).

Conclusions:

  • Later postnatal HIV-1 infection (after 1 month) is associated with better viral containment.
  • Maternal viral load is a key predictor of infant viral load.
  • Infant viral load and immune status are critical determinants of early mortality in vertically HIV-1-infected children.
Abstract

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