Pediatric Human Immunodeficiency Virus Screening in an African District Hospital

Baets, Anniek J. De; Edidi, B.; Kasali, Mwamba; Beelaert, Greet; Schrooten, Ward; Litzroth, Amber; Kolsteren, Patrick; Denolf, D; Fransen, Katrien

doi:10.1128/cdli.12.1.86-92.2005

Cited by 35 publications

(26 citation statements)

References 44 publications

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“…While these approaches might have proven cost-effective in some resource-lacking countries, with different cohorts, or even with different types of specimens (24,33,56,82), the impacts of the recommendations on diagnostic and detection outcomes are beyond immediate comprehension. In pursuing the recommended strategies, various combinations of test kits were reviewed and ultimately adopted in routine HIV testing.…”

Section: Standard and Alternative Algorithms For Confirmation Of Hiv mentioning

confidence: 99%

Frequency, Causes, and New Challenges of Indeterminate Results in Western Blot Confirmatory Testing for Antibodies to Human Immunodeficiency Virus

Guan

2007

Clin Vaccine Immunol

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Section: Standard and Alternative Algorithms For Confirmation Of Hiv mentioning

confidence: 99%

Frequency, Causes, and New Challenges of Indeterminate Results in Western Blot Confirmatory Testing for Antibodies to Human Immunodeficiency Virus

Guan

2007

Clin Vaccine Immunol

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“…Many studies of p24 antigen for diagnosis of HIV-1 infection have been conducted over the past several years, 49,[76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93] with the sensitivity of the assay increasing with increasingly effective techniques used to dissociate p24 antigen from anti-p24 antibody (immune complex-dissociated p24 antigen detection). 94 In general, p24 antigen assays have been used much less frequently than HIV-1 DNA-or RNA-amplification techniques for diagnosis of HIV-1 infection because of the relatively poor sensitivity of p24 antigen assays and the absence of readily available commercial, FDA-approved reagents.…”

Section: P24 Antigen Assaysmentioning

confidence: 99%

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Read¹

2007

Pediatrics

120

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The objectives of this technical report are to describe methods of diagnosis of HIV-1 infection in children younger than 18 months in the United States and to review important issues that must be considered by clinicians who care for infants and young children born to HIV-1–infected women. Appropriate HIV-1 diagnostic testing for infants and children younger than 18 months differs from that for older children, adolescents, and adults because of passively transferred maternal HIV-1 antibodies, which may be detectable in the child's bloodstream until 18 months of age. Therefore, routine serologic testing of these infants and young children is generally only informative before the age of 18 months if the test result is negative. Virologic assays, including HIV-1 DNA or RNA assays, represent the gold standard for diagnostic testing of infants and children younger than 18 months. With such testing, the diagnosis of HIV-1 infection (as well as the presumptive exclusion of HIV-1 infection) can be established within the first several weeks of life among nonbreastfed infants. Important factors that must be considered when selecting HIV-1 diagnostic assays for pediatric patients and when choosing the timing of such assays include the age of the child, potential timing of infection of the child, whether the infection status of the child's mother is known or unknown, the antiretroviral exposure history of the mother and of the child, and characteristics of the virus. If the mother's HIV-1 serostatus is unknown, rapid HIV-1 antibody testing of the newborn infant to identify HIV-1 exposure is essential so that antiretroviral prophylaxis can be initiated within the first 12 hours of life if test results are positive. For HIV-1–exposed infants (identified by positive maternal test results or positive antibody results for the infant shortly after birth), it has been recommended that diagnostic testing with HIV-1 DNA or RNA assays be performed within the first 14 days of life, at 1 to 2 months of age, and at 3 to 6 months of age. If any of these test results are positive, repeat testing is recommended to confirm the diagnosis of HIV-1 infection. A diagnosis of HIV-1 infection can be made on the basis of 2 positive HIV-1 DNA or RNA assay results. In nonbreastfeeding children younger than 18 months with no positive HIV-1 virologic test results, presumptive exclusion of HIV-1 infection can be based on 2 negative virologic test results (1 obtained at ≥2 weeks and 1 obtained at ≥4 weeks of age); 1 negative virologic test result obtained at ≥8 weeks of age; or 1 negative HIV-1 antibody test result obtained at ≥6 months of age. Alternatively, presumptive exclusion of HIV-1 infection can be based on 1 positive HIV-1 virologic test with at least 2 subsequent negative virologic test results (at least 1 of which is performed at ≥8 weeks of age) or negative HIV-1 antibody test results (at least 1 of which is performed at ≥6 months of age). Definitive exclusion of HIV-1 infection is based on 2 negative virologic test results, 1 obtained at ≥1 month of age and 1 obtained at ≥4 months of age, or 2 negative HIV-1 antibody test results from separate specimens obtained at ≥6 months of age. For both presumptive and definitive exclusion of infection, the child should have no other laboratory (eg, no positive virologic test results) or clinical (eg, no AIDS-defining conditions) evidence of HIV-1 infection. Many clinicians confirm the absence of HIV-1 infection with a negative HIV-1 antibody assay result at 12 to 18 months of age. For breastfeeding infants, a similar testing algorithm can be followed, with timing of testing starting from the date of complete cessation of breastfeeding instead of the date of birth.

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“…However, this may primarily be a problem with the acid-dissociated immune complex-disrupted assay and was not observed by other investigators (3, 17, 18, 22, 23). Many of the previous studies assessing the Up24 antigen assay sampled only children who were at least 6 weeks old (27) or did not discuss in detail the number of samples from those less than 1 month old (6,30,34). We tested 109 specimens from infants of 0 to 7 days of age and 151 specimens from infants of 8 to 30 days of age and had only four false positives.…”

mentioning

confidence: 99%

Ultrasensitive p24 Antigen Assay for Diagnosis of Perinatal Human Immunodeficiency Virus Type 1 Infection

et al. 2007

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Pediatric Human Immunodeficiency Virus Screening in an African District Hospital

Cited by 35 publications

References 44 publications

Frequency, Causes, and New Challenges of Indeterminate Results in Western Blot Confirmatory Testing for Antibodies to Human Immunodeficiency Virus

Frequency, Causes, and New Challenges of Indeterminate Results in Western Blot Confirmatory Testing for Antibodies to Human Immunodeficiency Virus

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Ultrasensitive p24 Antigen Assay for Diagnosis of Perinatal Human Immunodeficiency Virus Type 1 Infection

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