The clinical virology of pediatric HIV disease

Paul Palumbo

doi:10.1017/CBO9780511544798.007

4 - The clinical virology of pediatric HIV disease

from Part I - Scientific basis of pediatric HIV care

Published online by Cambridge University Press: 03 February 2010

Paul Palumbo

Edited by

Steven L. Zeichner and

Jennifer S. Read

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Paul Palumbo: Affiliation:
Departments of Pediatrics and of Biochemistry and Molecular Biology, UMDNJ-New Jersey Medical School, Newark, NJ
Steven L. Zeichner: Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read: Affiliation:
National Cancer Institute, Bethesda, Maryland

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Summary

The advent of potent antiretroviral therapy and effective prophylaxis for opportunistic infections has created a clear need for early diagnosis of HIV infection in pediatric patients and for methods of monitoring disease course and response to therapy. The field has undergone substantial progress within the past decade and innovations continue to emerge. Diagnostic issues will be addressed initially in this chapter, followed by virologic approaches for monitoring disease course and response to therapy.

Virologic assays for the diagnosis of pediatric HIV infection

Serology

Reports of the isolation of a human immunodeficiency virus (LAV; HTLV-III; later to be known as HIV-1) in 1984 [1–4] were quickly followed by the development of enzyme immunoassays (EIAs) capable of detecting a human antibody response to infection [5, 6]. It soon became clear that reactive EIAs required confirmation by Western blot to verify that the EIA-detected immune response was HIV-specific. While confirmation is essential for all EIA-reactive specimens, it is particularly important in low-risk populations where the positive predictive value of EIA is relatively low [7–10]. This issue has recently resurfaced in the context of rapid antibody tests, which can provide test results soon after the specimen is obtained at the same visit [11]. These rapid diagnostic tests can be performed in 10–30 minutes, an appealing feature for relatively non-compliant populations and for pregnant women at labor and delivery with an unknown HIV infection status.

Type: Chapter
Information: Textbook of Pediatric HIV Care , pp. 59 - 67

DOI: https://doi.org/10.1017/CBO9780511544798.007 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2005

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