EFFECT OF THE HIV-1 SYNCYTIUM-INDUCING PHENOTYPE ON DISEASE STAGE IN VERTICALLY-INFECTED CHILDREN

The syncytium-inducing (SI) capability of HIV-1 isolates from 48 HIV-i nfected children was determined in order to examine the association of the SI phenotype with an BIDS diagnosis and/or with other clinical pa rameters in HIV-infected children. In a retrospective cross-sectional analysis, phenotypic data were linked to clinical and immunologic data from each patient. Multiple longitudinal samples were analyzed from 1 4 patients. Children with SI viruses were older than children with non syncytium-inducing (NSI) strains. Twelve of 13 children less than 2 ye ars old carried NSI viruses, seven of the 12 already had a diagnosis o f AIDS. Two children under 2 years of age died within 1 month of NSI v irus isolation. Although plasma p24 antigen levels tended to be higher in the NSI group, the difference appeared to reflect high p24 levels in children under 2 years old with AIDS. When children under 2 were om itted, differences in age, CD4+ cell counts, p24 antigenemia, and clin ical parameters were not significant. The Si phenotype of HIV-l did no t occur more frequently in children with an AIDS diagnosis. Four child ren remained stable with Si isolates over time periods of 16 to 31 mon ths. Three children's isolates converted from NSI to SI and 2 converte d from Si to NSI. These data indicate that SI viruses do not play a si gnificant role in progression to BIDS during the first 2 years of life . Furthermore, for children above the age of 2, the association betwee n advanced disease stage and the SI phenotype in adults may not apply. (C) 1998 Wiley-Liss, Inc.