Phytohemagglutinin-inducible p24 in peripheral blood mononuclear cells as a predictor of human immunodeficiency virus type 1 vertical transmission and infant clinical status

• Published in: The Pediatric infectious disease journal Vol. 13; no. 12; p. 1079
• Main Authors: Farley, J J, Bauer, G, Johnson, J P, Cole, G A
• Format: Journal Article
• Language: English
• Published: United States 01.12.1994
• Subjects: Female; HIV Core Protein p24 - biosynthesis; HIV Core Protein p24 - blood; HIV Seropositivity - blood; HIV Seropositivity - congenital; HIV Seropositivity - transmission; HIV-1; Humans; Infant; Infant, Newborn; Infectious Disease Transmission, Vertical; Leukocytes, Mononuclear - metabolism; Lymphocyte Activation; Phytohemagglutinins - pharmacology; Pregnancy; Pregnancy Complications, Infectious - blood
• ISSN: 0891-3668; 1532-0987
• DOI: 10.1097/00006454-199412000-00002

We sought to determine whether the detectability of phytohemagglutinin-inducible p24 (PHA-p24) in short term cultures of peripheral blood mononuclear cells correlates with an increased risk of vertical transmission among human immunodeficiency virus type 1 (HIV-1)-infected pregnant women and more severe symptomatology among HIV-1-infected infants. The assay for PHA-p24 was performed on specimens obtained from HIV-1-infected women during their pregnancy and from infants during the first 6 months of life. Infants were followed prospectively to determine HIV-1 infection outcome and symptomatology. Among PHA-p24 positive women 9 of 19 (47.4%) gave birth to HIV-1-infected infants compared with 4 of 25 (16.0%) of PHA-p24-negative women (P = 0.02). Among women who tested PHA-p24-positive and had a CD4+ lymphocyte count < 500 cells/mm3, 8 of 15 (53.3%) gave birth to HIV-1-infected infants compared with 4 of 26 (15.4%) not meeting these conditions (P = 0.01). Among HIV-1-infected infants 4 of 5 (80%) of those testing PHA-p24-positive by one month of age developed an opportunistic infection or encephalopathy by 12 months of age, compared with none of the 11 infants testing PHA-p24-negative (P = 0.003). We conclude that PHA-p24 may be a useful in vitro measure for increased risk of vertical transmission among HIV-1-infected pregnant women and increased risk for rapid development of severe disease among HIV-1-infected infants.