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Human immunodeficiency virus type 1 antigenemia in children
W Borkowsky1, K Krasinski, D Paul
1Department of Pediatrics, New York University Medical Center, NY 10016.
Insights
Detecting human immunodeficiency virus type 1 (HIV-1) core antigen in children aids in diagnosing HIV infection and staging disease. Core antigen presence and levels correlate with symptomatic HIV-1 infection, particularly in infants and children with AIDS.
Area of Science:
- Virology
- Pediatric Infectious Diseases
- Immunology
Background:
- Human immunodeficiency virus type 1 (HIV-1) infection in children presents unique diagnostic and clinical management challenges.
- Early diagnosis and staging are crucial for effective intervention in pediatric HIV-1 infection.
Purpose of the Study:
- To evaluate the utility of HIV-1 core antigen detection in pediatric plasma for diagnosing HIV-1 infection.
- To correlate HIV-1 core antigen levels with the clinical stage of disease in children.
Main Methods:
- Plasma samples from children at risk for HIV-1 infection were assayed for core antigen.
- Antigen levels were quantified and correlated with clinical status (AIDS, AIDS-related illnesses, asymptomatic infection).
- Detection rates were analyzed across different age groups and clinical presentations.
Main Results:
- HIV-1 core antigen was detected in all children under 15 months with acquired immunodeficiency syndrome (AIDS).
- Core antigen was found in two-thirds of children with AIDS-related illnesses and half with asymptomatic infection.
- Quantitative antigen levels were significantly higher in children with AIDS compared to those with AIDS-related illnesses or asymptomatic infection.
Conclusions:
- HIV-1 core antigen detection is a valuable tool for diagnosing symptomatic HIV-1 infection in children, including young infants.
- Plasma core antigen levels correlate with disease severity and progression.
- Core antigen detection may be less frequent in asymptomatic children and was not detected at birth in infected newborns.
Abstract:
Human immunodeficiency virus type 1 (HIV-1) core antigen was assayed in the plasma of children at risk for infection with HIV to determine its usefulness in the diagnosis of infection and to correlate it with the clinical stage of disease. Antigen was detected in the plasma of all children less than 15 months of age with acquired immunodeficiency syndrome (AIDS). Two thirds of children with AIDS-related illnesses and half of children with asymptomatic infection had antigen. Although 53% of plasma specimens originating from HIV-infected children younger than 6 months of age contained antigen, only 25% of plasma specimens from children younger than 6 months who had no symptoms and none of the 10 specimens from HIV-infected newborn infants contained antigen. Half of the specimens containing core antigen also contained anticore antibody. Quantitative mean antigen levels were more likely to be elevated in children with AIDS (516 pg/ml) than in children with AIDS-related illnesses (295 pg/ml) or in those who had no symptoms (70 pg/ml). Antigen levels tended to increase over time in children with advancing clinical illness, but they tended to decrease over time after a diagnosis of AIDS was made. Antigen was detected in the plasma of 4 of 14 children without symptoms who subsequently reverted to an HIV seronegative state. We conclude that the detection of core antigen occurs with high frequency in children, even young infants, with symptomatic HIV infection. Plasma core antigen was less frequent in children without symptoms and was not detected in 10 infected children when they were tested at birth.