title: A comparative study of human immunodeficiency virus culture, polymerase chain reaction and anti-human immunodeficiency virus immunoglobulin A antibody detection in the diagnosis during early infancy of vertically acquired human immunodeficiency virus infection.
abstract: The infection status of 91 infants born to mothers with human immunodeficiency virus (HIV) infection was determined. Twenty-eight (31%) infants had confirmed HIV infection and 63 (69%) had seroreverted to HIV and lack evidence of infection. During the first 6 months of life HIV culture had a sensitivity and specificity for diagnosis of HIV infection of 80 and 100%, respectively. False negative HIV cultures were observed in only 7 of 35 specimens, 6 from among the 12 infected infants tested at birth. The sensitivity and specificity of polymerase chain reaction (PCR) detection of HIV were 95 and 93% respectively. A single false negative PCR test result was observed among the 19 tests performed on specimens from HIV-infected infants. False positive PCR test results were observed occasionally throughout the first 6 months of life. Detection of HIV-specific IgA antibody lacked diagnostic sensitivity; positive test results were observed in only 53% of specimens obtained from infected infants. Culture and PCR detection offer excellent sensitivity and specificity for diagnosis of HIV infection during the first 6 months of life; however, false-negative HIV cultures sometimes are observed, particularly during the newborn period, and either false negative or false positive PCR test results may be noted occasionally. For purposes of clinical decision-making, any positive test result should be confirmed with a second HIV culture or PCR test performed on a separate blood specimen.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030.
authors.forename: M W
authors.initials: MW
authors.lastname: Kline
authors.forename: D E
authors.initials: DE
authors.lastname: Lewis
authors.forename: F B
authors.initials: FB
authors.lastname: Hollinger
authors.forename: J M
authors.initials: JM
authors.lastname: Reuben
authors.forename: L C
authors.initials: LC
authors.lastname: Hanson
authors.forename: C A
authors.initials: CA
authors.lastname: Kozinetz
authors.forename: D H
authors.initials: DH
authors.lastname: Dimitrov
authors.forename: H M
authors.initials: HM
authors.lastname: Rosenblatt
authors.forename: W T
authors.initials: WT
authors.lastname: Shearer
mesh_terms: D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D015750:Genes, gag; D006678:HIV / Q000302:isolation & purification; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000635:transmission; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007223:Infant; D007231:Infant, Newborn; D016133:Polymerase Chain Reaction / Q000379:methods*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D012680:Sensitivity and Specificity
chemical_list: D015483:HIV Antibodies; D007070:Immunoglobulin A