Background: Long-term survival following infection with HIV-1 in adults has been shown to correlate with a low viral burden as measured by quantitation of plasma viral RNA levels. Although HIV-1 infected children have a more rapid progression to disease, understanding the determinants of survival in this group may have important therapeutic implications.

Methods: We identified three distinct groups of HIV-1 infected children with the goal of studying the viral determinants associated with long-term survival. Group I consisted children with rapidly progressive disease having AIDS-related symptoms within two years of infection, group II were long-term survivors who remained asymptomatic for at least 8 years following infection and had CD4+ counts of >500/mm3 and group III consisted of children remaining asymptomatic for at least 8 years following infection and with CD4+ counts <500/mm3. Plasma RNA levels were determined using the Amplicor assay (Roche Molecular Diagnostics).

Results: Table

Table 1
Full size table

Conclusion: Long term survival clearly ocurrs in HIV-1 infected children. Plasma viral RNA levels were significantly lower (p<0.05) in group II compared to the rapid progressors with two of the group II survivors having no detectable plasma RNA intermittently. Further characterization of the viral isolates from this unique group of infected children may shed insight into determinants of survival.