Does umbilical cord blood polymerase chain reaction positivity indicate in utero (pre-labor) HIV infection?
OBJECTIVE
To compare risk factors for infants whose cord blood was positive for HIV DNA with those who were cord blood-negative but found to be HIV DNA-positive in early infancy.


METHODS
In 1994, infants born to HIV-infected women were enrolled in a study in Blantyre, Malawi. Birth weight and transmission risk factors from cord blood-positive infants were compared with cord blood-negative/HIV-positive infants on their first postnatal visit (4-7 weeks of age). Testing for HIV DNA on cord and peripheral blood was performed by polymerase chain reaction.


RESULTS
Of 249 HIV-infected infants (overall transmission rate, 26%), 83 (33%) were cord blood-positive and 166 were initially cord blood-negative. The mean birth weight was 2.1% (59 g) lighter in cord blood-positive infants than initially cord blood-negative infants; initially cord blood-negative infants were 2.8% (80 g) lighter than uninfected infants born to HIV-infected women. There were no significant differences in the risk factors for infection between HIV-infected cord blood-positive and -negative infants; when transmission was increased, both HIV-infected cord blood-positive and -negative infants contributed to the increase in a similar proportion.


CONCLUSIONS
It was concluded that umbilical cord blood positivity for HIV DNA did not identity a subset of in utero HIV-infected infants and suggested that HIV-infected cord blood-positive and -negative infants have similar timing and routes of HIV infection.
Biggar
R J
RJ
Viral Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA.
Mtimavalye
L
L
Justesen
A
A
Broadhead
R
R
Miley
W
W
Waters
D
D
Goedert
J J
JJ
Chiphangwi
J D
JD
Taha
T E
TE
Miotti
P G
PG
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D005312:Fetal Blood / Q000276:immunology* / Q000821:virology*; D006678:HIV / Q000276:immunology / Q000302:isolation & purification*; D015483:HIV Antibodies / Q000276:immunology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D012307:Risk Factors
D004279:DNA, Viral; D015483:HIV Antibodies