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Diagnosis of perinatally acquired HIV infection.


Int Conf AIDS. 1990 Jun 20-23;6(3):132 (abstract no. S.B.208). Unique

OBJECTIVE: We looked at virological markers for HIV infection in infants born to HIV infected mothers to establish infection early in life. METHODS: Eleven infants (2 twins) stage P0 born to 9 HIV positive mothers were tested for HIV infection with 1) plasma P24 antigen (Ag) by EIA Ag-capture (Abbott), 2) plasma viraemia by plasma culture and 3) quantitative peripheral blood mononuclear cell (PBMC) coculture. Serial dilutions (10(3) to 10(6)) PBMC were cocultured with uninfected PHA-stimulated PBMC. The culture supernatants were harvested at day 14 and assayed for P24 Ag by EIA Ag-capture assay (Abbott). RESULTS: Ten of the 11 infants were asymptomatic at the time of the assay. All 11 infants had assays for both plasma P24 Ag and quantitative coculture while 6 of 11 had assays for plasma viraemia. TABULAR DATA, SEE ABSTRACT VOLUME. Of the 8 infants who were HIV positive on quantitative coculture 3 progressed to AIDS and 2 (twins) have died from P. Carinii pneumonia. The other 5 infants are asymptomatic. Three of the 5 asymptomatic infants had quantitative cord blood mononuclear cell cocultures. All cord blood cocultures were negative but 2 infants developed positive cocultures by 3 weeks of age and the quantitative PBMC cocultures were positive at 10(2) to 10(3) TCID per 10(6) cells. The negative coculture at birth and positive coculture by 3 weeks of age was concordant with polymerase chain reaction (PCR). The fact that these 2 infants were PCR and coculture negative at birth and converted to PCR and coculture positive suggests perinatal transmission in these infants. CONCLUSION: Quantitative coculture is useful for early identification of HIV positive infants and quantitation of viral load may be a useful prognostic indicator.

Acquired Immunodeficiency Syndrome/CONGENITAL/COMPLICATIONS/ *DIAGNOSIS/PHYSIOPATHOLOGY Antigens, Surface/*ANALYSIS Cells, Cultured Female Gene Products, gag/*IMMUNOLOGY Human HIV Antigens/*ANALYSIS HIV Seropositivity/CONGENITAL/COMPLICATIONS/PHYSIOPATHOLOGY Infant Infant, Newborn Leukocytes, Mononuclear/MICROBIOLOGY Polymerase Chain Reaction Prognosis Twins Viral Core Proteins/*IMMUNOLOGY Viremia/COMPLICATIONS/*DIAGNOSIS ABSTRACT


Information in this article was accurate in December 30, 1990. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.