title: Does umbilical cord blood polymerase chain reaction positivity indicate in utero (pre-labor) HIV infection?
abstract: 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.
authors.affiliation: Viral Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Biggar
authors.forename: L
authors.initials: L
authors.lastname: Mtimavalye
authors.forename: A
authors.initials: A
authors.lastname: Justesen
authors.forename: R
authors.initials: R
authors.lastname: Broadhead
authors.forename: W
authors.initials: W
authors.lastname: Miley
authors.forename: D
authors.initials: D
authors.lastname: Waters
authors.forename: J J
authors.initials: JJ
authors.lastname: Goedert
authors.forename: J D
authors.initials: JD
authors.lastname: Chiphangwi
authors.forename: T E
authors.initials: TE
authors.lastname: Taha
authors.forename: P G
authors.initials: PG
authors.lastname: Miotti
mesh_terms: 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
chemical_list: D004279:DNA, Viral; D015483:HIV Antibodies