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HIV‐1 ICD p24 antigen detection in Ugandan infants: Use in early diagnosis of infection and as a marker of disease progression
Author(s) -
Guay Laura A.,
Hom David L.,
Kabengera Sam R.,
PiwowarManning Estelle M.,
Kataaha Peter,
Ndugwa Christopher,
Marum Lawrence H.,
Kalyesubula Israel,
Jackson J. Brooks
Publication year - 2000
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/1096-9071(200012)62:4<426::aid-jmv6>3.0.co;2-s
Subject(s) - medicine , antigen , immunology , cohort , viral disease , human immunodeficiency virus (hiv) , disease , prospective cohort study , pediatrics , virology
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. J. Med. Virol. 62:426–434, 2000. © 2000 Wiley‐Liss Inc.