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.
Mussi-Pinhata
M M
MM
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
Cervi
M C
MC
Isaac
M L
ML
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