Persistent human immunodeficiency virus type 1 antigenemia in children correlates with disease progression

L. G. Epstein, C. A B Boucher, S. H. Morrison, E. M. Connor, J. M. Oleske, J. M A Lange, J. Van der Noordaa, M. Bakker, J. Dekker, H. Scherpbier, H. Van den Berg, K. Boer, J. Goudsmit

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

In a longitudinal study, human immunodeficiency virus type 1 (HIV-1) antigen (HIV Ag) was measured in serum specimens from 54 children with HIV-1 infection followed for a median duration of 17 months. The persistent detection of free HIV-Ag in a group of 25 children was associated with clinical deterioration in 22 (88%) and a mortality of 52%, whereas the persistent nondetection of free HIV-Ag in a group of 18 children was associated with clinical deterioration in five (28%) and a mortality of 11% during the period of observation. Nine children had transient HIV-1 antigenemia and two children converted from HIV-Ag negative to positive during the study. Free HIV-Ag levels varied inversely with antibody reactivity to viral core proteins p24 and p17 determined by Western immunoblot, suggesting either the formation of immune complexes or a balance between viral expression and the host immune response. Five mother-infant pairs were studied for HIV-Ag expression in the perinatal period. In three of these pairs, both mother and infant were HIV-Ag negative, in one pair the mother had high levels of HIV-Ag and the infant was HIV-Ag negative. In the remaining mother-infant pair, the neonate became HIV-Ag positive but the mother was HIV-Ag negative prepartum and postpartum. These data suggest that HIV-Ag probably does not cross the placenta and that the detection of free HIV-Ag in the offspring of a HIV-1 infected mother most likely indicates viral infection. Two children with persistently high levels of HIV-Ag were treated with the antiviral medication zidovudine and showed a decline in HIV-Ag levels, with a rebound in one when the medication was discontinued, adding further evidence that free HIV-Ag detection is a reliable indicator of viral expression.

Original languageEnglish (US)
Pages (from-to)919-924
Number of pages6
JournalPediatrics
Volume82
Issue number6
StatePublished - 1988

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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