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Boosted p24 antigen assay for early diagnosis of perinatal HIV infection
Orasri Wittawatmongkol1, Nirun Vanprapar, Pimpanada Chearskul
1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Insights
The boosted-p24 antigen assay is an accurate and affordable tool for diagnosing perinatal HIV infection in infants. It shows high accuracy when administered between 4-6 months of age.
Area of Science:
- Medical Diagnostics
- Infectious Diseases
- Pediatrics
Background:
- Perinatal HIV infection remains a significant global health concern.
- Accurate and timely diagnosis in infants is crucial for effective management and improved outcomes.
- Existing diagnostic methods may have limitations in resource-limited settings.
Purpose of the Study:
- To evaluate the diagnostic accuracy of an in-house boosted-p24 antigen assay for perinatal HIV infection.
- To determine the assay's performance at different infant ages (1-2 months and 4-6 months).
Main Methods:
- Retrospective review of medical records of infants born to HIV-positive mothers.
- Testing infants using the boosted-p24 antigen assay at 1-2 months and 4-6 months of age.
- HIV infection defined by serological or virological criteria at 18 months or older, or positive HIV-PCR with clinical symptoms.
Main Results:
- The study included 168 infants, with six confirmed HIV-infected cases.
- At 1-2 months, the boosted-p24 assay showed 33.33% sensitivity and 98.27% specificity.
- At 4-6 months, the assay demonstrated 100% sensitivity, 98.27% specificity, and 100% negative predictive value.
Conclusions:
- The boosted-p24 antigen assay is a potentially cost-effective alternative for diagnosing perinatal HIV infection.
- The assay's accuracy significantly improves when performed at 4-6 months of age.
- This assay holds promise for enhancing early infant diagnosis of HIV, particularly in resource-constrained environments.
Objective:
The authors evaluated the accuracy of in-house boosted-p24 antigen assay for diagnosis of perinatal HIV infection.
Material And Method:
The author has retrospectively reviewed the medical records of infants born to HIV-positive mothers. The infants were tested for boosted-p24 antigen assay at the age of 1-2 months and 4-6 months. HIV infection was defined as positive anti-HIV at the age 18 months or older, or had positive HIV-PCR with clinical signs and symptoms compatible with HIV/AIDS.
Results:
There were 168 infants included in this review and six were HIV-infected. The boosted-p24 antigen assay had the sensitivity, specificity, positive predictive value, and negative predictive value of 33.33%, 98.27%, 50%, and 95.8%, respectively at 1-2 month-old, and 100%, 98.27%, 71.43%, and 100%, respectively at 4-6 month-old.
Conclusion:
Boosted-p24 antigen assay could be a cheaper alternative test to help diagnosis of perinatal HIV infection in infants. The test was very accurate when performed at 4-6 months.
