LONG-TERM RESISTANCE TO HIV-INFECTION IN VERTICAL HIV-INFECTION - CYTOKINE PRODUCTION, HIV ISOLATION, AND HIV PHENOTYPE DEFINE LONG-TERM RESISTANT HOSTS

We analyzed immunologic (CD4 and CD8 slopes; interferon-gamma, interle ukin-2, interleukin-10, and chemokines production; concentration of Ig E; beta(2)-microglobulin) and virologic (p24; HIV isolability and phen otype; plasma viremia) parameters in HIV vertically infected children greater than or equal to 8 years of age without disease progression or mild symptoms and an absolute CD4+ count greater than or equal to 500 /mu l with CD4+ percentage greater than or equal to 25%. The results w ere compared to those of two control groups: (1) slow progressors, chi ldren greater than or equal to 8 years of age with moderate symptomato logy and/or moderate CD4 depletion, and (2) progressors, children grea ter than or equal to 8 years of age with severe clinical disease and/o r severe CD4 depletion. Pediatric long-term resistant hosts were chara cterized by higher production of interleukin-2 and interferon-gamma an d lower production of interleukin-10, normal concentration of IgE, HIV Isolates with a non-syncytium-inducing phenotype, and lower plasma vi remia. This condition was not associated with the concentration of bet a(2)-microglobulin, p24, and chemokines, or with HIV isolability. The IL-1O/IL-2 ratio best correlated with both CD4 counts and disease prog ression. Thus, vertically infected children showing resistance to dise ase progression are immunologically and virologically distinct from th ose in whom progressive HIV infection is observed.