Specific IgA can be used for perinatal diagnosis of HIV infection in children under protocol 076.

MARTINEZ PERALTA L; CEBALLOS A; LIBERATORE D; BIGLIONE M; PANDO MA; AVILA MM

Durban

Conferencia; XIII International AIDS Conference; 2000

IAS

Background: The detection of anti-HIV IgA has been already described as a useful tool for the diagnosis of perinatally acquired HIV infection using Western blot; dot blot as well as ELISA assays. However, the efficiency of this test has not been evaluated in children under protocol 076 to prevent vertical transmission. The aim of this work was to compare the efficiency of specific IgA for perinatal diagnosis in children treated and untreated with protocol 076. Methods: A total of 177 sera were obtained from 141 infants between 1 and 12 months of age (46 were treated and 95 were non-treated with protocol ACTG 076) and tested for HIV IgA antibodies by a modified commercial ELISA test after removal of IgG with recombinant protein G. Infants were classified according to CDC’s classification system after follow up until 20 months of age: of the 46 treated children 22 turned to be infected and in the group of 95 untreated children 51 were infected. Results: Considering that the sensitivity of this test is lower in children younger than 6 months the population of children studied was divided in under and over 6 months of age. No significant differences were observed in the detection of IgA in treated or untreated children in both age groups (p=1.00 for children <6 months and p=0.12 for children >6 months, Fisher exact test). The distribution of asymptomatic and symptomatic children was fairly even in all the groups. The overall specificity of the test was 100%; sensitivity in children older than 6 months was 76.92% in treated children and 93,10% in untreated children. Conclusions: In spite of the short number of samples studied it would be demonstrated that the treatment with ZDV doesn’t interfere with the detection of the specific IgA antibodies. This is a simple and inexpensive method that could be used for perinatal diagnosis of treated and untreated children irrespective of their clinical status.