Abstract:
:The objective of this study was to determine the use of immune-complex dissociated (ICD) p24 antigen detection for the diagnosis and prognosis of HIV-1 infection in Ugandan children. Plasma collected prospectively from children born to HIV-1 infected Ugandan women was stored and later analyzed for the presence of neutralizable HIV-1 p24 antigen using the Coulter ICD p24 antigen and neutralization kits. HIV-1 infection status, disease progression, and survival of the children were determined. Specimens from 311 children born to HIV-1 infected women, including 138 HIV-1 infected children, and 113 children born to negative women were tested. Sixty-nine (50%) infected children were p24 antigen positive at least once. For early HIV-1 diagnosis, the specificity and positive predictive value of the assay were consistently high (>95% and >83% respectively), but the sensitivity was low (6-53%), especially in the first months of life. The presence of p24 antigenemia in the first two years of life was associated with poor survival (20%) by 80 months of age compared with infected children without antigenemia (43%, P < 0.001). Early detection of p24 antigen (=2 months) was associated with higher mortality than first detection at an older age (>6 months, P < 0.001). The data suggest that ICD p24 antigen detection is not a sensitive method for the determination of infant HIV-1 status in our cohort of HIV-1 infected Ugandan children tested in the first two years of life. There was a strong correlation, however, between the presence and time of onset of p24 antigenemia and mortality among HIV-1 infected children.
journal_name
J Med Viroljournal_title
Journal of medical virologyauthors
Guay LA,Hom DL,Kabengera SR,Piwowar-Manning EM,Kataaha P,Ndugwa C,Marum LH,Kalyesubula I,Jackson JBdoi
10.1002/1096-9071(200012)62:4<426::aid-jmv6>3.0.cokeywords:
subject
Has Abstractpub_date
2000-12-01 00:00:00pages
426-34issue
4eissn
0146-6615issn
1096-9071pii
10.1002/1096-9071(200012)62:4<426::AID-JMV6>3.0.COjournal_volume
62pub_type
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