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Arch Dis Child 1999;80:132-136 ( February )

Viral loads in dual infection with HIV-1 and cytomegalovirus

Yuri S Boriskin,a Mike Sharland,b Ruth Dalton,c Gill duMont,d James C Bootha

a Department of Medical Microbiology, St George's Hospital Medical School, Cranmer Terrace, London SW17 ORE, UK, b Paediatric Infectious Diseases Unit, St George's Hospital Medical School, c Department of Ophthalmology, St George's Hospital Medical School, d Department of Paediatrics, St Thomas's Hospital, London SE1 7EH, UK

Correspondence to: Dr Boriskin.


Accepted 5 October 1998

OBJECTIVE---A one year study of the relation between cytomegalovirus (CMV) and human immunodeficiency virus (HIV) viral loads in a cohort of children with vertically acquired HIV-1 infection.
DESIGN---Comparative analysis of viral load measurements for CMV and HIV-1 in peripheral blood leucocytes (PBLs) of individual children in relation to age and clinical staging.
METHODS---Nested polymerase chain reaction (PCR) was used to measure HIV-1 proviral DNA and CMV genomic DNA in PBLs of 56 children.
RESULTS---The CMV load was highest in 0-2 year old HIV positive children with stage C disease (range, 1-7143 copies/100 ng DNA; median, 125) and was significantly lower in older children. Although higher in young children, HIV-1 viral load did not show the same marked reduction with age that is seen with CMV. Over a one year period, testing of serial samples for both viruses in a subgroup of children revealed a discordant relation between viral loads for CMV and HIV-1.
CONCLUSIONS---CMV viral load falls much faster than HIV viral load in dually infected children. Screening for clinical CMV disease is most likely to be of benefit in children under 2 years of age with stage C disease. In the few children studied, levels of CMV and HIV replication appear to be independent.

Keywords: cytomegalovirus; human immunodeficiency virus; viral load

© 1999 by Archives of Disease in Childhood


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