title: The utility of IgA antibody to human immunodeficiency virus type 1 in early diagnosis of vertically transmitted infection. National Institute of Allergy and Infectious Diseases and National Institute of Child Health and Human Development Women and Infants Transmission Study Group.
abstract: OBJECTIVE
  To determine the sensitivity and specificity of anti-human immunodeficiency virus (HIV) IgA in identifying infected infants at or before 6 months of age among the offspring of HIV-infected mothers.
  
  
  METHODS
  Prospective comparison of anti-HIV IgA measurement performed in 2 different laboratories by 2 different methods with the criterion standard of blood culture.
  
  
  METHODS
  Five centers in the United States and Puerto Rico.
  
  
  METHODS
  Population-based sample of 156 infants of HIV-infected mothers in the Women and Infants Transmission Study.
  
  
  METHODS
  Results of anti-HIV IgA test in relation to the infection status of the infants as measured by blood culture.
  
  
  RESULTS
  Six-month plasma or serum samples were first tested in the 2 laboratories. The sensitivity and specificity of anti-HIV IgA in detecting infected infants at this age by laboratories 1 and 2 were 69% and 63% and 100% and 99%, respectively. A look-back study of samples obtained at birth, 1, 2, and 4 months was then performed on all infected children and a matched set of uninfected children. The performance of the test at birth was unsatisfactory in both laboratories (sensitivity 44% and 33%, specificity 43% and 60%), whether peripheral or cord blood was examined. At 1, 2, and 4 months, the sensitivity of the test was lower than at 6 months, but specificity was high. A modest correlation of absent anti-HIV IgA antibody and low percentage of CD4 cells in peripheral blood was seen at 6 months of age.
  
  
  CONCLUSIONS
  The anti-HIV IgA test has moderate sensitivity and high specificity for the diagnosis of HIV infection at 6 months of age in the offspring of infected mothers.
authors.affiliation: Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, Mass, USA.
authors.forename: K
authors.initials: K
authors.lastname: McIntosh
authors.forename: A M
authors.initials: AM
authors.lastname: Comeau
authors.forename: D
authors.initials: D
authors.lastname: Wara
authors.forename: C
authors.initials: C
authors.lastname: Diaz
authors.forename: S
authors.initials: S
authors.lastname: Landesman
authors.forename: J
authors.initials: J
authors.lastname: Pitt
authors.forename: K
authors.initials: K
authors.lastname: Rich
authors.forename: J
authors.initials: J
authors.lastname: Lew
authors.forename: J
authors.initials: J
authors.lastname: Moye
authors.forename: L A
authors.initials: LA
authors.lastname: Kalish
mesh_terms: D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology / Q000635:transmission*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011647:Puerto Rico; D012680:Sensitivity and Specificity; D014481:United States
chemical_list: D015483:HIV Antibodies; D007070:Immunoglobulin A