Balotta C, Colombo M C, Colucci G, Viganò A, Riva C, Papagno L, Violin M, Crupi L, Bricalli D, Salvaggio A, Moroni M, Principi N, Galli M
Clinica delle Malattie Infettive, University of Milan, Italy.
Pediatr Infect Dis J. 1997 Feb;16(2):205-11. doi: 10.1097/00006454-199702000-00008.
To analyze the relationships among HIV-1 plasma viremia, phenotype and CD4 T cell counts in vertically infected children.
Plasma viremia was quantified in 37 vertically infected children at different stages of the disease by a standardized molecular assay. Virus isolation and non-syncytia-inducing or syncytia-inducing (SI) HIV-1 phenotype evaluation were performed in parallel.
HIV-1 RNA genomes were found to be significantly different in CDC clinical classes N, A, B and C (P = 0.0135) and in immunologic classes 1, 2 and 3 (P = 0.0110). None of the children in Class N or A harbored HIV-1 isolates with SI phenotype, whereas SI primary isolates were detected in 2 of 7 (29%) and 7 of 10 (70%) Class B and C children, respectively. Similarly SI variants were present in only 9 of 13 children in immunologic Class 3 (70%). When stratified according to the increasing severity of virologic status, the children showed a significant difference (P = 0.0458) in viral burden.
Clinical symptoms, the most dramatic being reduction in the number of CD4 lymphocytes, and the highest plasma viremia levels were observed in the children in whom fast replicating, highly cytopathic SI variants were isolated. These data extend the virologic characterization of vertically HIV-1 infected children and suggest that both the plasma viremia levels and phenotype of primary isolates are viral correlates of disease progression in vertically infected children.
分析垂直感染儿童中HIV-1血浆病毒血症、表型与CD4 T细胞计数之间的关系。
采用标准化分子检测方法，对37名处于疾病不同阶段的垂直感染儿童的血浆病毒血症进行定量分析。同时进行病毒分离及非合胞体诱导型或合胞体诱导型（SI）HIV-1表型评估。
发现HIV-1 RNA基因组在疾病控制中心（CDC）临床分类N、A、B和C组中存在显著差异（P = 0.0135），在免疫分类1、2和3组中也存在显著差异（P = 0.0110）。N组或A组儿童中无一例携带SI表型的HIV-1分离株，而在B组儿童中有2/7（29%）、C组儿童中有7/10（70%）检测到SI原发性分离株。同样，在免疫分类3组的13名儿童中只有9名（70%）存在SI变异株。根据病毒学状态严重程度递增进行分层时，儿童在病毒载量方面存在显著差异（P = 0.0458）。
在分离出快速复制、高细胞病变性SI变异株的儿童中，观察到了临床症状，其中最显著的是CD4淋巴细胞数量减少以及最高的血浆病毒血症水平。这些数据扩展了垂直感染HIV-1儿童的病毒学特征，并表明原发性分离株的血浆病毒血症水平和表型均为垂直感染儿童疾病进展的病毒相关因素。
