THE AMOUNT OF EARLY P24 ANTIGENEMIA AND NOT THE TIME OF FIRST DETECTION OF VIRUS PREDICTS THE CLINICAL OUTCOME OF INFANTS VERTICALLY INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

Twenty-three children vertically infected with human immunodeficiency virus type 1 (HIV-1) were studied for viremia during the first days of life, Nine had HIV-1 infection within the first week (early); 14 had HIV-1 first detected by day 11-90 (late), The groups had similar incid ence and time of onset of symptomatic HIV-1 infection and survival, CD 4 T cell percentages, rates of CD4 T cell attrition, quantitative cell -associated viremia, and p24 antigen concentrations were comparable, C hildren with peak antigen concentrations >100 pg/mL during the first 6 months (5 early, 6 late) fared worse than those with lower p24 levels , Thus, HIV-1-infected infants with detectable virus in the first few days of life do not have a worse prognosis than infants whose virus is detectable only later, Elevated p24 antigenemia during the first 6 mo nths of life correlates strongly with poor clinical outcome and is ind ependent of the time that virus was first detected.