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Instituto Nacional de Salud Pública

2004, Number 1

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salud publica mex 2004; 46 (1)

IgA antibody detection and PCR as first options in the diagnosis of perinatal HIV-1 infection

Basualdo MC, Moran K, Alcántara P, González E, Puentes E, Soler C

Language: Spanish
References: 38
Page: 49-55
PDF size: 106.31 Kb.


ABSTRACT

Objective. To evaluate the sensitivity and specificity of the polymerase chain reaction (PCR), enzyme-linked immunosorbent assay (ELISA) and IgA-specific immunoblot assays as ancillary methods to diagnose human immunodeficiency virus (HIV-1) perinatal infection. Material and Methods. A comparative study was conducted between February and October 2001 at the Human Retrovirus Research Unit of Mexico’s National University. Ninety infected and 153 noninfected children were included in the study. Viral cultures were the gold standard tests. Standardized PCR for a conserved region of the gag gene and HIV-specific IgA antibody using ELISA and immunoblot were used. Statistical analysis of results was performed with SPSS 10.0. Results. IgA ELISA sensitivity and specificity were 61.1% and 90.8%, respectively. Immunoblot had a sensitivity of 82.2% and a specificity of 95.4%. PCR had an overall sensitivity of 98.3% and a specificity of 100% with only one false negative result. If both assays were run, the sensitivity increased to 100% and the specificity to 96%. Conclusions. A very high sensitivity and specificity is reached when using together PCR and IgA immunoblot; these assays are useful for perinatal diagnosis of HIV-1.


REFERENCES

  1. 1.Newell ML, Peckham C. Risk factors for vertical transmission of HIV-1 and early markers of HIV-I infection in childmen.AIDS 1993;7: S591 -S597.

  2. 2.Van de Perre P. Postnatal transmission of human immunodeficiency virus type I:The breast-feeding dilemma.Am J Obstet Gynecol 1995; 173:483-487.

  3. 3.Committee on Pediatric AIDS. Human milk, breastfeeding and transmission of human immunodeficiency virus in the United States. Pediatrics 1995; 96:977-979.

  4. 4.Schdpbach J,Tomasik Z,Jends j, Bóni j, Seger R, Kind Ch et al. IgG, IgM and 4g.A response to HIV ir Infants born to H1V-1 infected mothers.] A.cquir immune Detc Syndr 1994: 7:421-427.

  5. 5.European Collaborative Study. Mother-to-child transmision of HIV infection. Lancet 1988; ii: 1039-1042.

  6. 6.Moodley D, Bobat RA, Coutsoudis A, Coovadia HM. Predicting perinatal human immunodeficiency virus infection by antibody patterns. Pediatr Infect Dis J 1995; 14: 850-852.

  7. 7.Desrosiers RC.Virus purification, preparation of infectious virus stock, and virus storage. En:Aldovini A,Walker B, Ed.Techniques in HIV research. Nueva York (NY): Stockton Press; 1990: 121-127.

  8. 8.Livingston RA, Hutton N, Halsey NA, Kline RL, Joyner M, QuinnTC. Human immunodeficiency virus-specific IgA in infants born to human immunodeficiency virus-seropositive women.Arch PediatrAdolesc Med 1995; 149: 503-507.

  9. 9.Clerici M, Levin JM, Kessler HA, Harris A, Berzofsky JA Landay AL et al. HIV-specific T-helper activity in seronegative health care workers exposed to contaminated blood. JAMA 1994; 271: 42-46.

  10. 10.Riegelman RK, Hirsch RP. Cómo estudiar un estudio y probar una prueba: lectura crítica de la literatura médica. 2a. ed.Washington, DC: Organización Panamericana de la Salud; 1992; Publicación Científica No. 531: 112-122.

  11. Kline MW, Lewis DE, Hollinger FB, Reuben JM, Hanson C, Kozinetz CA et al. A comparative study of human immunodeficiency virus culture, poymerase chain reaction and anti-human immunodeficiency virus immunoglobulin A antibody detection in the diagnosis during early infancy of vertically acquired human immunodeficiency virus infection. Pediatr Infect Dis J 1994; 13:90-94.

  12. Quinn TC, Kline RL, Halsey N, Hutton N, Ruff A, Butz A et al. Early diagnosis of perinatal HIV infection by detection of viral-specific IgA antibodies. JAMA 1991; 266: 3439-3442.

  13. 13.McIntosh K, Comeau AM,Wara D, Díaz C, Landesman S, Pitt J et al. The utility of IgA antibody to human immunodeficiency virus type I in early diagnosis of vertical transmitted infection.Arch PediatrAdolesc Med 1996;150:598-602.

  14. 14.Report of consensus workshop on early diagnosis of HIV infection in infants: Siena, Italy. J Acquir Immune Defic Syndr 1992, 5:1 169-1 178.

  15. 15.Henrard D, Fauvel J, Samson G, Delege M, Boucher C and Hankins J. Ontogeny of the humoral immune response to humanimmunodeficiency virus type I in infants.) Infect Dis 1993;168:288-291.

  16. 16.Martin NL, Levy JA, Legg H,Weintrub PS, Cowan MJ,Wara D. Detection of infection with human immunodeficiency virus (HIV) type 1 in infants by an anti-HIV immunoglobulin A assay using recombinant proteins.J Pediatr 1991;118:354-358.

  17. I7. Weiblen BJ, Lee FK, Cooper ER, Landesman S, McIntosh K, Harris JA et al. Early diagnosis of HIV infection in infants by detection of IgA HIV antibodies. Lancet 1990; 335:988-990.

  18. Newell ML, Loveday C, Dunn D, Kaye S,Tedder R, Peckham C et al. Use of Polymerase chain reaction and quantitative antibody tests in children born to human immunodeficiency virus-I infected mothers.J Med Virol 1995; 47:330-335.

  19. Wiznia AA, Lambert G, Dobrosyzcki J, Porricolo M, Chelyapov N, Israeli V et al. Virologic, immunologic and clinical evaluation of human immunodeficiency virus antibody status of symptom-free children born to infected mothers. J Pediatr 1994;125:352-355.

  20. Newell ML, Peckham C. Risk factors for vertical transmission of HIV-1 and early markers of HIV-1 infection in children. AIDS 1993;7: S591-S597.

  21. Van de Perre P. Postnatal transmission of human immunodeficiency virus type 1: The breast-feeding dilemma. Am J Obstet Gynecol 1995; 173:483-487.

  22. Committee on Pediatric AIDS. Human milk, breastfeeding and transmission of human immunodeficiency virus in the United States. Pediatrics 1995; 96:977-979.

  23. Schdpbach J, Tomasik Z, Jends J, Bóni J, Seger R, Kind Ch et al. IgG, IgM and IgA response to HIV in Infants born to HIV-1 infected mothers. J Acquir Immune Defic Syndr 1994:7:421-427.

  24. European Collaborative Study. Mother-to-child transmision of HIV infection. Lancet 1988; ii: 1039-1042.

  25. Moodley D, Bobat RA, Coutsoudis A, Coovadia HM. Predicting perinatal human immunodeficiency virus infection by antibody patterns. Pediatr Infect Dis J 1995; 14: 850-852.

  26. Desrosiers RC. Virus purification, preparation of infectious virus stock, and virus storage. En: Aldovini A, Walker B, Ed. Techniques in HIV research. Nueva York (NY): Stockton Press; 1990: 121-127.

  27. Livingston RA, Hutton N, Halsey NA, Kline RL, Joyner M, Quinn TC. Human immunodeficiency virus-specific IgA in infants born to human immunodeficiency virus-seropositive women. Arch Pediatr Adolesc Med 1995; 149: 503-507.

  28. Clerici M, Levin JM, Kessler HA, Harris A, Berzofsky JA, Landay AL et al. HIV-specific T-helper activity in seronegative health care workers exposed to contaminated blood. JAMA 1994; 271: 42-46.

  29. Riegelman RK, Hirsch RP. Cómo estudiar un estudio y probar una prueba: lectura crítica de la literatura médica. 2a. ed. Washington, DC: Organización Panamericana de la Salud; 1992; Publicación Científica No. 531: 112-122.

  30. Kline MW, Lewis DE, Hollinger FB, Reuben JM, Hanson C, Kozinetz CA et al. A comparative study of human immunodeficiency virus culture, poymerase chain reaction and anti-human immunodeficiency virus immunoglobulin A antibody detection in the diagnosis during early infancy of vertically acquired human immunodeficiency virus infection. Pediatr Infect Dis J 1994; 13:90-94.

  31. Quinn TC, Kline RL, Halsey N, Hutton N, Ruff A, Butz A et al. Early diagnosis of perinatal HIV infection by detection of viral-specific IgA antibodies. JAMA 1991; 266: 3439-3442.

  32. McIntosh K, Comeau AM, Wara D, Díaz C, Landesman S, Pitt J et al. The utility of IgA antibody to human immunodeficiency virus type 1 in early diagnosis of vertical transmitted infection. Arch Pediatr Adolesc Med 1996;150:598-602.

  33. Report of consensus workshop on early diagnosis of HIV infection in infants: Siena, Italy. J Acquir Immune Defic Syndr 1992, 5:1169-1178.

  34. Henrard D, Fauvel J, Samson G, Delege M, Boucher C and Hankins J. Ontogeny of the humoral immune response to humanimmunodeficiency virus type 1 in infants. J Infect Dis 1993;168:288-291.

  35. Martin NL, Levy JA, Legg H, Weintrub PS, Cowan MJ, Wara D. Detection of infection with human immunodeficiency virus (HIV) type 1 in infants by an anti-HIV immunoglobulin A assay using recombinant proteins. J Pediatr 1991;118:354-358.

  36. Weiblen BJ, Lee FK, Cooper ER, Landesman S, McIntosh K, Harris JA et al. Early diagnosis of HIV infection in infants by detection of IgA HIV antibodies. Lancet 1990; 335:988-990.

  37. Newell ML, Loveday C, Dunn D, Kaye S, Tedder R, Peckham C et al. Use of Polymerase chain reaction and quantitative antibody tests in children born to human immunodeficiency virus-1 infected mothers. J Med Virol 1995; 47:330-335.

  38. Wiznia AA, Lambert G, Dobrosyzcki J, Porricolo M, Chelyapov N, Israeli V et al. Virologic, immunologic and clinical evaluation of human immunodeficiency virus antibody status of symptom-free children born to infected mothers. J Pediatr 1994;125:352-355.




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