Viral load in HIV-infected children on high activity antiretroviral therapy

BACKGROUND AND OBJECTIVE: To determine whether viral load (W prior to undetectable VL has predictive value on the re-emergence of VL (> 400 copies/ml, > 5,000 copies/ml and > 30,000 copies/ml). PATIENTS AND METHOD: Retrospective study carried out on 81 vertically human immunodeficiency virus (HIV)-infected children on antiretroviral therapy who were distributed in 3 groups according to their median value of VL one year before reaching undetectable VL: A-group: VL < 5,000 copies/ml; B-group: VL between 5,000 and 30,000 copies/ml, and C-group: VL > 30,000 copies/ml. RESULTS: During the whole follow-up period, 63 (77.8%) children had a rebound of VL > 400 copies/ml. Forty-two (51.8%) children had a rebound of VL > 5,000 copies/ml. Twenty-seven (33.3%) children had a rebound of VL > 30,000 copies/ml. HIV-children of B-group had values of hazard ratio (HR) statistically significant for a rebound of VL > 5,000 copies/ml. Moreover, HIV-children of C-group had values of HR greater and statistically significant for a rebound of VL > 500, > 5,000 and > 30,000 copies/ml. For a rebound of VL > 30,000 copies/ml, the C-group had values of RR > 12. CONCLUSIONS: High VL levels prior to undetectable VL can be a useful prognostic marker of virological failure in HIV-infected children.