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Virus load as a marker of disease progression in HIV-infected children
1Department of Pediatrics, North Shore University Hospital-Cornell University Medical College, Manhasset, New York 11030, USA.
Insights
Human immunodeficiency virus (HIV)-infected children have higher cell-associated virus loads early in life. This increased viral load is particularly associated with rapid disease progression in young children.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- The relationship between human immunodeficiency virus (HIV) viral load and clinical disease progression in children is not fully understood.
- Understanding this relationship is crucial for managing pediatric HIV infection.
Purpose of the Study:
- To investigate the association between cell-associated HIV-1 proviral DNA load and disease progression in HIV-infected children.
- To compare viral loads in different age groups and disease progression categories.
Main Methods:
- Quantitative competitive DNA polymerase chain reaction (QC-PCR) assay was used to measure HIV-1 proviral DNA load in peripheral blood mononuclear cells (PBMCs).
- 47 HIV-infected children were analyzed, categorized by age (< or = 2 years vs. > or = 5 years) and disease progression (rapid vs. slow progressors).
Main Results:
- Significantly higher mean proviral DNA copies were detected in younger children (group I) compared to older children (group II).
- Rapid progressors (RP) exhibited substantially higher proviral DNA loads than slow progressors (SP) and other age-matched children.
- A strong correlation was observed between higher cell-associated virus load and rapid disease progression in early childhood.
Conclusions:
- HIV-infected children, especially those under 2 years old, tend to have a higher cell-associated virus load.
- Elevated proviral DNA load early in life is a significant indicator of rapid disease progression in pediatric HIV infection.
Abstract:
The relationship of virus load to clinical disease progression in HIV-infected children remains to be elucidated. In this study, HIV-1 proviral DNA load was determined in peripheral blood mononuclear cells (PBMCs) by the quantitative competitive DNA polymerase chain reaction assay (QC-PCR) in 47 HIV-infected children subdivided by age (group I, < or = 2 years; group II, > or = 5 years), who were further categorized to include 12 rapid progressors (RP, age < or = 2 years, Centers for Disease Control [CDC] defined clinical category C and/or immune category 3, or death before age 2 years) and slow progressors (SP, age > or = 5 years, excluding CDC categories C and/or immune category 3). Significantly higher mean proviral copies/10(3) PBMCs were detected in group I versus group II (75.4 +/- 104.3 and 13.0 +/- 17.8 respectively, p < 0.0001) and in RP (158.0 +/- 118.2) as compared to either SP (11.8 +/- 18.8, p < 0.0001) or other age-matched infected children (20.3 +/- 38.8, p < 0.0001). Thus HIV-infected children appear to have a higher cell-associated virus load early in life, especially in association with rapid disease progression.