Human immunodeficiency virus type 1 (HIV-1)-specific antibody-dependent cellular cytotoxicity (ADCC) antibody titers were serially measured from birth to 24 months in the plasma of 14 intrapartum-infected and 10 uninfected infants born to HIV-1-infected women. The mean ADCC antibody titers measured at birth in infected and uninfected infants were similar (10(-3.9) and 10(-4.0), respectively), suggesting that ADCC antibodies did not protect infants from the intrapartum transmission of HIV-1. In infected infants, ADCC titers at birth did not predict subsequent clinical disease course. The active production of HIV-1-specific ADCC antibodies was detected in most infected infants only after 12 months of age, well after the loss of passively acquired maternal ADCC antibody. The delayed production of ADCC antibodies in infancy may account, in part, for the less efficient control of viral replication and more rapid disease progression following vertical infection compared with that in adults.