Use of semiquantitative human immunodeficiency virus type 1 culture to guide therapy in a premature infant

Semiquantitative cultures for human immunodeficiency virus type 1 were used to initiate and guide therapy in an asymptomatic, heavily infected premature infant. The cultures were performed on fivefold serial dilutions of peripheral blood mononuclear cells, and viral growth was detected by the appearance of p24 antigen in the supernatant. While the patient was receiving low-dose zidovudine, her titer diminished from 206 infectious units per 10⁶ cells to undetectable levels over 20 weeks, and she remained asymptomatic throughout her 1st year of life. This case suggests that semiquantitative HIV-1 culture should be further evaluated for its ability to guide practical therapeutic decisions in patients who do not fulfill currently established criteria for treatment.