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Specific IgA detection can be used for perinatal diagnosis of HIV in children under protocol ACTG 076
A Ceballos1, D Liberatore, M Biglione
1National Reference Center for AIDS, Department of Microbiology, University of Buenos Aires School of Medicine, Argentina.
Insights
A modified ELISA test effectively detects anti-HIV-1 IgA antibodies for early diagnosis in infants. This simple, inexpensive method aids early HIV-1 infection diagnosis in children, even those on zidovudine treatment.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- Diagnostic Assays
Background:
- Early diagnosis of perinatally acquired Human Immunodeficiency Virus type 1 (HIV-1) infection in infants is crucial for timely intervention.
- The ACTG 076 protocol, involving zidovudine treatment, aims to reduce perinatal HIV-1 transmission.
- Evaluating diagnostic methods that are effective in treated infants is essential.
Purpose of the Study:
- To assess the utility of a modified ELISA test for detecting anti-HIV-1 IgA antibodies for early diagnosis of perinatally acquired HIV-1 infection in infants.
- To determine if zidovudine treatment affects the detection of HIV-1 IgA antibodies.
Main Methods:
- A modified ELISA test was developed to detect anti-HIV-1 IgA antibodies, with prior removal of IgG using recombinant protein G.
- Sera from 141 infants (1-12 months old), including 46 treated and 95 untreated with the ACTG 076 protocol, were analyzed.
- Infants were followed up to 20 months for classification according to CDC criteria.
Main Results:
- All 81 samples from uninfected children were IgA-negative, indicating 100% specificity.
- HIV IgA antibodies were detected in 56% of treated infected children and 82% of untreated infected children.
- Sensitivity in children over 6 months was 76.92% for treated and 93.10% for untreated groups, suggesting treatment does not interfere with IgA detection.
Conclusions:
- The modified ELISA test is a specific and potentially sensitive method for diagnosing HIV-1 infection in infants.
- Zidovudine treatment does not appear to affect the detection of anti-HIV-1 IgA antibodies.
- This simple, inexpensive assay holds promise for early HIV-1 diagnosis in children, particularly in resource-limited settings.
Abstract:
Detection of anti-HIV-1 IgA antibodies using a modified ELISA test for the early diagnosis of perinatally acquired HIV-1 infection in children treated with protocol ACTG 076 was evaluated. 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 an ELISA test after removal of IgG with recombinant protein G. Infants were classified according to CDC's classification system after a follow-up until 20 months of age. Of the 46 treated children 22 turned out to be infected and in the group of 95 untreated children, 52 were infected. All 81 samples from uninfected children treated or untreated with protocol ACTG 076 were persistently IgA-negative. HIV IgA antibodies were detected in 14 of 25 plasma samples from infected children with treatment, and in 58 of 71 samples in infected children without treatment. Considering that the sensitivity of this test is lower in children younger than 6 months the population of children studied was divided into two groups; those under and those over 6 months of age. No significant differences were observed in the detection of IgA in treated or untreated children in both age groups. The overall specificity of the test was 100 per cent; sensitivity in children older than 6 months was 76.92 per cent in treated children and 93.10 per cent in untreated children. In spite of the small number of samples studied it could be demonstrated that treatment with zidovudine does not affect the detection of IgA antibodies. This is a simple and inexpensive method that could be used for diagnosis of treated and untreated children in developing countries.
