VIRUS LOAD AS A MARKER OF DISEASE PROGRESSION IN HIV-INFECTED CHILDREN

The relationship of virus load to clinical disease progression in HIV- infected children remains to be elucidated. In this study, HIV-1 provi ral DNA load was determined in peripheral blood mononuclear cells (PBM Cs) by the quantitative competitive DNA polymerase chain reaction assa y (QC-PCR) in 47 HIV-infected children subdivided by age (group I, les s than or equal to 2 years; group II, greater than or equal to 5 years ), who were further categorized to include 12 rapid progressors (RP, a ge less than or equal to 2 years, Centers for Disease Control [CDC] de fined clinical category C and/or immune category 3, or death before ag e 2 years) and slow progressors (SP, age greater than or equal to 5 ye ars, excluding CDC categories C and/or immune category 3), Significant ly higher mean proviral copies/l0(3) PBMCs were detected in group I ve rsus group II (75.4 +/- 104.3 and 13.0 +/- 17.8 respectively, p <0.000 1) 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-asso ciated virus load early in life, especially in association with rapid disease progression.