Virus levels in untreated African infants infected with human immunodeficiency virus type 1

In developed areas, human immunodeficiency virus (HIV)-infected infants hav e high virus levels and rapidly progress to death. HIV levels were assessed in 1994-1997 in untreated infants in Malawi by analysis of dried blood spo ts tested by nucleic acid silica-bound amplification. Of 24 umbilical cord blood (CB)-positive samples, 83% had >10,000 copies/mL. The median virus le vel was 78,000 copies/mL. First positive sample median levels were 355,000 copies/mL among 52 perinatally infected infants and 130,000 copies/mL among 43 infants infected by breast-feeding. Virus levels were stable, and initi al levels predicted Levels 1 year after infection (P = .005), at which time levels did not significantly differ among in utero, perinatally, or postna tally infected infants. Thus, neither age at infection nor route of infecti on significantly influenced HIV levels measured 1 year after infection, Mos t (87%) CB-positive infants were infected before labor onset, since virus l evels greatly exceeded those expected in their mothers.