Abstract
Background: Long-term survival following infection with HTV-1 in adults has been shown to correlate with a low viral burden as measured by quantitation of plasma viral RNA levels. Although HTV-1 infected children have a more rapid progression to disease, understanding the determinants of survival in this group may have important therapeutic implications. Methods: We identified three distinct groups of HIV-1 infected children with the goal of studying the viral determinants associated with long-term survival. Croup I consisted children with rapidly progressive disease having AIDS-related symptoms within two years of infection, group n were long-term survivors who remained asymptomatic for at least 8 years following infection and had CD4+ counts of >500/mm3 and group in consisted of children remaining asymptomatic for at least 8 years following infection and with CD4+ counts <50G/mm3. Plasma RNA levels were determined using the Amplicor assay (Roche Molecular Diagnostics). Results: Group/n Ageyrs CD4+/mm3 plasma RNA copies/ml (mean) (mean) (mean) 1/5 1.73 372(+/-218.6) 1.03 × 106 H/5 11.2 1002.8 (=/- 217.5) 2.3 × 105 lu/S 10.2 320 (=/-95.1) 7.7×104 Conclusion: Long term survival clearly ocurrs in HIV-1 infected children. Plasma viral RNA levels were significantly lower (p<0.05) in group II compared to the rapid progresser; with two of the group n survivors having no detectable plasma RNA intermittently. Further characterization of the viral isolates from this unique group of infected children may shed insight into determinants of survival.