Effect of maternal CD4 cell count, acquired immunodeficiency syndrome, and viral load on disease progression in infants with perinatally acquired human immunodeficiency virus type 1 infection |
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| Authors: | Genevieve Lambert MD Donald M. Thea MD Vadim Pliner PhD Richard W. Steketee MD Elaine J. Abrams MD Pamela Matheson PhD Pauline A. Thomas MD Barbara Greenberg PhD Teresa M. Brown Marukh Bamji MD Marcia L. Kalish PhD |
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| Affiliation: | Bronx, Harlem, and New York, New York and Atlanta, Georgia;From the Department of Pediatrics, Bronx Lebanon Hospital Center; the Medical and Health Research Association of New York; the Department of Pediatrics, Harlem Hospital Center; New York City Department of Health; Albert Einstein College of Medicine; and the Department of Pediatrics, Metropolitan Hospital Center, Bronx, Harlem, and New York, New York; and the Centers for Disease Control and Prevention, Atlanta, Georgia |
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| Abstract: | Among a cohort of 152 infants perinatally infected with human immunodeficiency virus type 1, and their mothers, we correlated infant outcome with maternal CD4 + lymphocyte count and the presence of maternal acquired immunodeficiency syndrome near delivery. In a subset of 50 mother-infant pairs, we also correlated infant outcome with maternal quantitative viral burden as measured by the nucleic acid sequence based amplification system. We found that low maternal CD4 + cell count and high viral burden were associated with decreased time to category C disease or death in infants infected with human immunodeficiency virus type 1. In a multivariate analysis, high maternal viral load and maternal acquired immunodeficiency syndrome were independently associated with shorter time to category C disease or death in infants with human immunodeficiency virus type 1 infection. High viral load in pregnant women, independent of the presence of advanced maternal disease, appears to increase the risk of rapidly progressive disease in their infected offspring. (J Pediatr 1997;130:830-7) |
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| Keywords: | Abbreviations: AIDS, Acquired immunodeficiency syndrome CDC, Centers for Disease Control and Prevention CI, Confidence interval HIV-1, Human immunodeficiency virus type 1 PCR, Polymerase chain reaction RNA, Ribonucleic acid VL, Viral load ZDV, Zidovudine |
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