title: Diagnosis of human immunodeficiency virus type 1 infection in infants by immune complex dissociation p24 assay.
abstract: Using immune complex dissociation (ICD), we retrospectively examined serum and plasma of 206 infants aged 0 to 4 months who were perinatally exposed to human immunodeficiency virus (HIV). All samples were analyzed in a blinded manner. Infection status was determined based on the results of HIV culture and Centers for Disease Control and Prevention classification. The overall diagnostic sensitivity of the assay was 59% (93 samples, 73 infants), and specificity was 100% (160 samples, 133 infants). When the samples were analyzed according to age, sensitivity was highest at age 1 to 2 months (17 of 21 infants, 81%). Sensitivities at other ages were 53% at < 1 month, 55% at 2 to 3 months, and 48% at 3 to 4 months (9 of 17, 11 of 20, and 12 of 25 cases, respectively). In 11 evaluable cases there was a possible correlation of p24 antigen quantitation (in picograms per milliliter) with disease progression. We conclude that, as determined in this study, the ICD p24 is a rapid diagnostic assay for HIV infection with a sensitivity of >80% at 1 to 2 months of age and 100% specificity, as evaluated, up to 4 months of age.
authors.affiliation: Department of Pediatrics, North Shore University Hospital-Cornell University Medical College, Manhasset, New York 11030, USA.
authors.forename: M O
authors.initials: MO
authors.lastname: Paul
authors.forename: G
authors.initials: G
authors.lastname: Toedter
authors.forename: D
authors.initials: D
authors.lastname: Hofheinz
authors.forename: S
authors.initials: S
authors.lastname: Tetali
authors.forename: S
authors.initials: S
authors.lastname: Pelton
authors.forename: M
authors.initials: M
authors.lastname: Marecki
authors.forename: A
authors.initials: A
authors.lastname: Brena
authors.forename: E J
authors.initials: EJ
authors.lastname: Abrams
authors.forename: S
authors.initials: S
authors.lastname: Landesman
authors.forename: S
authors.initials: S
authors.lastname: Pahwa
mesh_terms: D000936:Antigen-Antibody Complex / Q000378:metabolism*; D015483:HIV Antibodies / Q000378:metabolism; D016655:HIV Core Protein p24; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007158:Immunologic Techniques; D007223:Infant; D007231:Infant, Newborn; D007700:Kinetics
chemical_list: D000936:Antigen-Antibody Complex; D015483:HIV Antibodies; D016655:HIV Core Protein p24