RESUMEN
This article describes results from a cross-sectional study among HIV-infected children 15 months to 12 years of age who were receiving antiretroviral therapy. We found a low prevalence of measles IgG seropositivity (45.7%) and identified CD4% ≥ 25 as a predictor. Most HIV-infected children on ART were not measles seropositive and might benefit from revaccination.
Asunto(s)
Antirretrovirales/uso terapéutico , Anticuerpos Antivirales/sangre , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , Sarampión/virología , Adulto , Recuento de Linfocito CD4 , Niño , Preescolar , Estudios Transversales , Femenino , Infecciones por VIH/epidemiología , Infecciones por VIH/inmunología , Seroprevalencia de VIH , Humanos , Lactante , Kenia/epidemiología , Masculino , Sarampión/epidemiología , Sarampión/inmunología , Vacuna Antisarampión/administración & dosificaciónRESUMEN
BACKGROUND: There is limited information regarding the pattern and correlates of viral replication in vertically HIV-1-infected children and its role on their outcomes in resource-limited settings. METHODS: HIV-1-infected infants were followed from birth to 24 months. Serial HIV-1 RNA levels were compared in infants infected in utero (<48 hours), peripartum (48 hours-1 month), and late postnatal (after 1 month). Cofactors for viral peak [highest viral load (VL) within 6 months of infection] and set point and mortality were determined. RESULTS: Among 85 HIV-1-infected infants, 24 were infected in utero, 41 peripartum, 13 late postnatal; 7 had no 48-hour assay. HIV-1 VL set point was significantly lower in infants infected >1 month vs. < or = 1 month (5.59 vs. 6.24 log10 copies per milliliter, P = 0.01). Maternal VL correlated with peak infant VL (P < 0.001). Univariately, infant peak and set point VL and 6-month CD4% <15% predicted mortality; and 6-month CD4% <15% remained independently predictive in multivariate analyses (hazard ratio = 4.85, 95% confidence interval: 1.90 to 12.36). CONCLUSIONS: Infants infected after the age of 1 month contained virus better than infants infected before 1 month of age. Maternal VL predicted infant VL, which, in turn was associated with early mortality.
