Predicting perinatal HIV infection in young Brazilian infants: How accurate are signs, symptoms and immunological abnormalities?
Early identification of infants perinatally infected with HIV (HIV+) requires costly laboratory tests which are not widely available in countries with limited resources. We evaluated the utility of detection of non-specific HIV-related signs and symptoms and immunological abnormalities in the diagnosis of perinatal HIV infection in Brazilian infants younger than 10 months of age and followed from birth. A total of 27 HIV+ and 43 uninfected infants were studied. All infants exhibited one or more non-specific HIV-related findings at least once. HIV+ infants were more frequently symptomatic than HIV- infants only when older than 3 months. Combinations of clinical and immunological findings resulted in high sensitivity (85-100%) and low specificity (25-65%) rates for the diagnosis of HIV infection. Conversely, low CD4+ cell counts and hyperimmunoglobulinaemia showed low sensitivity (52%) and high specificity (100%) rates. In conclusion, the detection of similar findings in HIV- and HIV+ infants underscores the need of early confirmatory laboratory testing.
Department of Paediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Campus USP, 14049 900 Ribeirão Preto, São Paulo, Brazil. mmmpinha@fmrp.br
M M
MM
Mussi-Pinhata
M C
MC
Cervi
M L
ML
Isaac
D015415:Biomarkers / Q000097:blood; D001938:Brazil; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006679:HIV Seropositivity / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006785:Hospitals, University; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007223:Infant; D007231:Infant, Newborn; D012680:Sensitivity and Specificity
D015415:Biomarkers; D007136:Immunoglobulins