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7 - Diagnosis of HIV-1 infection in children

from Part II - General issues in the care of pediatric HIV patients

Published online by Cambridge University Press:  03 February 2010

By
Paul Krogstad
Edited by
Steven L. Zeichner  and
Jennifer S. Read
Paul Krogstad
Affiliation:
Associate Professor, Departments of Pediatrics and Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA
Steven L. Zeichner
Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read
Affiliation:
National Cancer Institute, Bethesda, Maryland
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Summary

Effective management of pediatric HIV-1 infection begins with timely and accurate diagnosis. In infants, early diagnosis is essential. Life-threatening immunodeficiency can develop rapidly and unpredictably, and there are no laboratory or clinical characteristics that accurately predict rapid or slow disease progression [1]. Studies in adults and children have shown that very early treatment can slow the progression of immunodeficiency and preserve HIV-1-specific immune responses. Early detection of HIV-1 infection among pregnant women is necessary to optimize medical care for the HIV-1-infected woman and to prevent mother-to-child transmission of HIV-1. This chapter outlines the use of serology, virus culture, and molecular diagnostic methods to detect HIV-1 infection in children.

HIV-1 diagnostic assays

Detection of antibodies to HIV-1

In 1985, enzyme-linked immunosorbent (ELISA) and immunoblot (Western blot) assays were licensed in the USA for detection of HIV-1-specific IgG antibodies in serum. While other tests are now available, they remain the mainstay for serological diagnosis of infection.

A large number of ELISA-based testing kits for antibody detection of HIV-1 specific antibodies are currently licensed by the US Food and Drug Administration. Early examples employed lysates from HIV-1-infected cell culture to provide HIV-1 antigen material. More recently developed assays often use a mixture of recombinant proteins, and some contain antigens that permit detection of antibodies to HIV-2 as well as antibody responses to HIV-1 (see below).

Type
Chapter
Information
Textbook of Pediatric HIV Care , pp. 105 - 110
Publisher: Cambridge University Press
Print publication year: 2005

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References

King, S. M.; American Academy of Pediatrics Committee on Pediatric Acquired Immune Deficiency Syndrome; American Academy of Pediatrics Infections Diseases and Immunization Committee. Evaluation and treatment of the human immunodeficiency virus-1 exposed infant. Pediatrics 114: 2 (2004), 497–505CrossRefGoogle Scholar
Janssen, R. S., Satten, G. A., Stramer, S. L.. New testing strategy to detect early Human Immunodeficiency Virus-1 infection for use in incidence estimates and for clinical and prevention purposes. J. Am. Med. Assoc. 280 (1998), 42–8CrossRefGoogle ScholarPubMed
Machado, D. M., Delwart, E. L., Diaz, R. S.. Use of the sensitive/less-sensitive (detuned) Enzyme Immunoassay strategy for targeting genetic analysis of Human Immunodeficiency Virus-1 to recently infected blood donors. Acquired Immune Deficiency Syndrome 16 (2002), 113–19Google ScholarPubMed
Centers for Disease Control and Prevention. Revised Guidelines for Human Immunodeficiency Virus Counseling, Testing, and Referral. Technical Expert Panel Review of Centers for Disease Control and Prevention Human Immunodeficiency Virus Counseling, Testing and Referral Guidelines. MMWR 50: Relative Risk-19 (2001), 1–57
Bylund, D. J., Ziegner, U. H. & Hooper, D. G.Review of testing for human immunodeficiency virus. Clin. Lab. Med. 12 (1992), 305–33Google ScholarPubMed
Centers for Disease Control and Prevention. Interpretation and use of the Western blot assay for serodiagnosis of human immunodeficiency virus type 1 infections. MMWR 38 (1989), 1–7
Centers for Disease Control. Update: Human Immunodeficiency Virus Counseling and Testing using Rapid Tests — United States, 1995. MMWR 11 (1998), 211–15
Minkoff, H. & Sullivan, M. J.The case for rapid Human Immunodeficiency Virus testing during labor. J. Am. Med. Assoc. 279 (1998), 1743–4CrossRefGoogle ScholarPubMed
Nielsen, K. & Bryson, Y. J.Diagnosis of Human Immunodeficiency Virus infection in children. Pediatr. Clin. North. Am. 47 (2000), 39–63CrossRefGoogle ScholarPubMed
Dunn, D. T., Brandt, C. D., Krivine, A.. The sensitivity of Human Immunodeficiency Virus-1 Deoxyribonucleic Acid polymerase chain reaction in the neonatal period and the relative contributions of intra-uterine and intra-partum transmission. Acquired Immune Deficiency Syndrome 9 (1995), F7–11Google Scholar
Shearer, W. T., Quinn, T. C., LaRussa, P.. Viral load and disease progression in infants infected with human immuno-deficiency virus type 1. Women and Infants Transmission Study Group. New Engl. J. Med. 336 (1997), 1337–42CrossRefGoogle ScholarPubMed
Delamare, C., Burgard, M., Mayaux, M. J.. Human Immunodeficiency Virus-1 Ribonucleic Acid detection in plasma for the diagnosis of infection in neonates. The French Pediatric Human Immunodeficiency Virus Infection Study Group. J. Acquired Immune Deficiency Syndrome Hum. Retrovirol. 15 (1997), 121–5CrossRefGoogle Scholar
Simonds, R. J., Brown, T. M., Thea, D. M.. Sensitivity and specificity of a qualitative Ribonucleic Acid detection assay to diagnose Human Immunodeficiency Virus infection in young infants. Perinatal Acquired Immune Deficiency Syndrome Collaborative Transmission Study. Acquired Immune Deficiency Syndrome 12 (1998), 1545–9Google ScholarPubMed
Frenkel, L. M., Mullins, J. I., Learn, G. H.. Genetic evaluation of suspected cases of transient Human Immunodeficiency Virus-1 infection of infants. Science 280 (1998), 1073–7CrossRefGoogle ScholarPubMed
Miles, S. A., Balden, E., Magpantay, L.. Rapid serologic testing with immune-complex-dissociated Human Immunodeficiency Virus p24 antigen for early detection of Human Immunodeficiency Virus infection in neonates. Southern California Pediatric Acquired Immune Deficiency Syndrome Consortium. New Engl. J. Med. 328 (1993), 297–302CrossRefGoogle Scholar
Schupbach, F. M., Pontelli, D., Tomasik, Z., Luty, R. & Boni, J.Heat-mediated immune complex dissociation and enzyme-linked immunosorbent assay signal amplification render p24 antigen detection in plasma as sensitive as Human Immunodeficiency Virus-1 Ribonucleic Acid detection by polymerase chain reaction. Acquired Immune Deficiency Syndrome 10 (1996), 1085–90Google ScholarPubMed
Schupbach, B. J., Tomasik, Z., Jendis, J., Seger, R. & Kind, C.Sensitive detection and early prognostic significance of p24 antigen in heat-denatured plasma of human immunodeficiency virus type 1-infected infants. Swiss Neonatal Human Immunodeficiency Virus Study Group. J. Infect. Dis. 170 (1994), 318–24CrossRefGoogle Scholar
Hollinger, F. B., Bremer, J. W., Myers, L. E., Gold, J. W. & McQuay, L.Standardization of sensitive human immuno-deficiency virus coculture procedures and establishment of a multicenter quality assurance program for the Acquired Immune Deficiency Syndrome Clinical Trials Group. The National Institutes of Health/National Institute of Allergy and Infectious Diseases/DAIDS/Acquired Immune Deficiency Syndrome Clinical Trials Group Virology Laboratories. J. Clin. Microbiol. 30 (1992), 1787–94Google Scholar
Centers for Disease Control and Prevention. 1994 revised classification system for human immunodeficiency virus infection in children less than 13 years of age. MMWR 43: Relative Risk-12 (1994), 1–10. (Updates available at http://AIDSInfo.nih.gov)
Owens, D. K., Holodniy, M., McDonald, T. W., Scott, J. & Sonnad, S.A meta-analytic evaluation of the polymerase chain reaction for the diagnosis of Human Immunodeficiency Virus infection in infants. J. Am. Med. Assoc. 275 (1996), 1342–8CrossRefGoogle Scholar
Centers for Disease Control and Prevention. Recommendations of the U.S. Public Health Service Task Force on the use of zidovudine to reduce perinatal transmission of human immunodeficiency virus. MMWR 44 (1995), 1–20
McCutchan, F. Global diversity in Human Immunodeficiency Virus. In K. Crandall (ed.), Evolution of Human Immunodeficiency Virus. Baltimore, MD: The John Hopkins University Press (1999)
Robertson, D. L., Anderson, J. P. & Bradac, J. A.Human Immunodeficiency Virus-1 nomenclature proposal. Science 288 (2000), 55–6CrossRefGoogle ScholarPubMed
Bogh, M., Machuca, R. & Gerstoft, J.Subtype-specific problems with qualitative Amplicor Human Immunodeficiency Virus-1 Deoxyribonucleic Acid Polymerase Chain Reaction test. J. Clin. Virol. 20 (2001), 149–53CrossRefGoogle Scholar
Rouet, F., Montcho, C. & Rouzioux, C.Early diagnosis of paediatric Human Immunodeficiency Virus-1 infection among African breast-fed children using a quantitative plasma Human Immunodeficiency Virus Ribonucleic Acid assay. Acquired Immune Deficiency Syndrome 15 (2001), 1849–56Google Scholar

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  • Diagnosis of HIV-1 infection in children
    • By Paul Krogstad, Associate Professor, Departments of Pediatrics and Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.010
Available formats
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To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Diagnosis of HIV-1 infection in children
    • By Paul Krogstad, Associate Professor, Departments of Pediatrics and Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.010
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Diagnosis of HIV-1 infection in children
    • By Paul Krogstad, Associate Professor, Departments of Pediatrics and Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA
  • Edited by Steven L. Zeichner, National Cancer Institute, Bethesda, Maryland, Jennifer S. Read, National Cancer Institute, Bethesda, Maryland
  • Book: Textbook of Pediatric HIV Care
  • Online publication: 03 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544798.010
Available formats
×