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Maternal viral load tied to HIV progression in offspring
  By David Douglas
NEW YORK (Reuters Health) - In vertically HIV-infected children, maternal perinatal viral load is an independent predictor of disease progression, European and US researchers report in the January 2nd issue of AIDS.
As lead investigator Dr. John P. A. Ioannidis told Reuters Health, "the study shows that when an infant is infected with HIV from its mother, the amount of virus in the mother at the time of delivery can tell us how rapidly disease will progress in the child in the first 6 months of its life."
Dr. Ioannidis of the University of Ioannina, Greece and colleagues came to this conclusion following meta-analysis of data from 8 studies involving 574 HIV-1 infected infants and their mothers.
Maternal HIV-1 RNA at or close to delivery correlated with early infant HIV-1 RNA. A higher maternal HIV-1 during this period had a borderline effect on mortality and significantly increased the risk of disease progression (hazard ratio 1.25).
In fact, the investigators note that "the risk of infant disease progression almost doubles for each 10-fold increase in maternal HIV-1 RNA levels." However, no such effect was seen after the first six months of life. No major differences in viremia were seen between mother and infants whether or not they were treated.
"There is some interesting symmetry between how much virus replicates in the mother and how much virus replicates eventually in the early-infected child," Dr. Ioannidis said.
AIDS 2004;18:99-107.


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