Trends in human immunodeficiency virus type 1 (HIV-1) load among HIV-1-infected children with hemophilia

In human immunodeficiency virus type 1 (HIV-1)-infected persons, virus load (serum/plasma level of HIV) predicts outcome. Virus load trends have been characterized in adults and infants but not in children. Virus load trends in 22 male children with hemophilia who acquired HIV-1 postnatally (age 0.7 -5.2 years at seroconversion) were studied. The mean HIV-1 load 2 years aft er seroconversion was 4.40 log(10) copies/mL, and the mean change over time (slope) was 0.03 log(10) copies/(mL . year). Significant among-children va riation was apparent: a random effects model predicted that 95% of children had early virus loads 3.75-5.04 log(10) copies/mL and slopes -0.07 to 0.12 log(10) copies/(mL . year). Higher early virus loads and higher slopes wer e each associated with increased mortality ( and, respectively). In P = .00 6 P = .03 conclusion, those subjects had virus load trends similar to those in adults. Early virus loads were lower than those in vertically infected infants, which suggests that factors changing soon after birth affect viral replication.