title: Testing cord blood human chorionic gonadotropin as a surrogate marker for early identification of human immunodeficiency virus-1 infection in children.
abstract: We measured human chorionic gonadotropin (hCG) in cord sera of 22 infants born to women infected with the human immunodeficiency virus-1 (HIV-1). hCG was also determined in cord sera from 173 infants born at a suburban hospital to HIV-1-seronegative women. The findings indicate that 16 (9%) of 173 HIV-1-seronegative samples had hCG levels greater than 90 IU/L (values were distributed as a Poisson curve). In contrast, 8 (36%) of the 22 infants born to HIV-1-infected women had hCG levels in excess of 90 IU/L, and 7 (88%) of these were shown to be HIV-infected. The remaining 14 infants born to HIV-1-infected women had low hCG levels, and 3 (21%) of the 14 had HIV infection. Mean follow-up time for HIV-uninfected infants was 17.5 months (range 9 months to 3 years). A statistically significant association between maternal-fetal HIV-1 transmission and hCG levels > or = 90 IU/L in cord sera was observed (p = 0.02). The difference between CD4 counts among mothers who transmitted HIV and those who did not was also statistically significant (p = 0.025). On the basis of this study's findings, we propose that cord blood hCG may serve as a surrogate marker for HIV-1 infection. Testing hCG levels in cord sera is an inexpensive and readily available screening test for early identification of infants at increased risk for getting HIV-1 from their mothers.
authors.affiliation: Department of Pediatrics, School of Medicine, University Medical Center, Stony Brook, N.Y., USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Nachman
authors.forename: F I
authors.initials: FI
authors.lastname: Chasalow
authors.forename: M
authors.initials: M
authors.lastname: Navaie-Waliser
authors.forename: S L
authors.initials: SL
authors.lastname: Blethen
authors.forename: P
authors.initials: P
authors.lastname: Tropper
mesh_terms: D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D018791:CD4 Lymphocyte Count; D006063:Chorionic Gonadotropin / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005500:Follow-Up Studies; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000635:transmission; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006063:Chorionic Gonadotropin