HIV DNA blood levels in vertically infected pediatric patients: Variations with age, association with disease progression, and comparison with blood levels in infected mothers

Blood levels of HIV DNA in our vertically infected pediatric patients typically followed a characteristic age-related pattern: continuously increasing with increasing age to a peak between ages 4 and 8 months, and thereafter rather steadily declining. Median HIV DNA levels peaked about 3 months earlier in children who by age 24 months developed more severe rather than less severe HIV disease. Children at particular risk of developing severe HIV disease by age 24 months commonly had >800 HIV DNA copies per 0.1 mi of blood at age 3 weeks to 2 months, >1,000 copies at 2 to 4 months, and >2,500 copies at ages 4 to 6 months. Near the time of delivery, mothers who transmitted HIV had significantly higher median blood levels of HIV DNA than mothers who did not transmit, but median HIV DNA levels in infected mothers as a group were low compared with those in pediatric patients st month of age.