Correlation of virus load and soluble L-selectin, a marker of immune activation, in pediatric HIV-1 infection

Objective: HIV infections in children are characterized by high viral load and, in some perinatally infected newborns, delayed appearance of viral mar kers. Both phenomena may be related to different levels of immune activatio n affecting viral replication. This study was designed to investigate the r elationship between immune activation and viral replication in pediatric HI V infection, and the role of pre-existent immune activation in facilitating HIV transmission to the fetus/newborn. Design: Plasma levels of soluble L-selectin (s-LS), an immune activation ma rker, were determined in 100 infants with perinatally transmitted HIV infec tion, compared with 106 age-matched HIV-exposed uninfected controls. Includ ed in the analysis were samples from 31 HIV-infected (10 PCR+ and 21 PCR-) and 35 uninfected newborns aged <2 days. Methods: To determine s-LS levels, a solid phase ELISA was performed on pla sma samples of patients and controls. Results: s-LS levels in uninfected children were higher than those in norma l adults. HIV-infected patients had more rapidly increasing values in the f irst 6 months of life compared with uninfected infants. Plasma s-LS levels correlated with HIV viral loads (r, 0.50). Among newborns in the first 2 da ys of life, s-LS levels were lowest in those with negative PCR tests, compa red with PCR-positive or uninfected infants. Conclusions: These results suggest that higher immune activation in childre n contributes to higher viral loads, and that the level of pre-existent imm une activation may have a role in determining which infants have detectable virus in peripheral blood at (C) 2000 Lippincott Williams & Wilkins.