CORRELATION OF RIBONUCLEIC-ACID POLYMERASE CHAIN-REACTION, ACID DISSOCIATED P24 ANTIGEN, AND NEOPTERIN WITH PROGRESSION OF DISEASE - A RETROSPECTIVE, LONGITUDINAL-STUDY OF VERTICALLY ACQUIRED HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION IN CHILDREN

Objective; We investigated the relationship between cell-free viral lo ad, neopterin, age-adjusted CD4(+) cell concentration, and clinical ev ents in 49 children with vertically acquired human immunodeficiency vi rus type 1 infection. Study design: Viral load was measured by quantit ating viral ribonucleic acid in serum by polymerase chain reaction and measurement of immune complex dissociated p24 antigen in serum and pl asma, Children were followed for an average of 2 1/2 years, with an av erage of 6 samples per child, Medical records were reviewed for weight , CD4(+) cell count, and clinical events. Results: High virus copy num ber in serum was predictive of a decrease in weight-for-age z score du ring the subsequent 6 months. High vital load, low CD4(+) cell count, and high neopterin level were correlated with encephalopathy, High vir al load correlated with opportunistic infections, All of these relatio nships field regardless of treatment status, although viral load decre ased significantly otter treatment was begun, Conclusions: Measurement s of viral load were useful prognostic indicators for poor weight gain , Elevated serum virus levels and neopterin values and low CD4(+) cell counts were all associated with encephalopathy.