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Seroreversion in human immunodeficiency virus-exposed but uninfected infants
C J Chantry1, E R Cooper, S I Pelton
1Department of Pediatrics, University of Puerto Rico School of Medicine, San Juan.
The Pediatric Infectious Disease Journal
|May 1, 1995
Summary
Seroreversion, or antibody loss, in HIV-exposed but uninfected infants typically occurs around 11-16 months. High initial antibody levels correlate with longer seroreversion times, validating current HIV infection diagnostic criteria.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Human immunodeficiency virus (HIV)-exposed but uninfected (HEU) infants can serorevert, losing HIV antibodies acquired passively from their mothers.
- Understanding seroreversion timelines is crucial for accurate diagnosis and management of HEU infants.
Purpose of the Study:
- To describe seroreversion (SR) in a cohort of HEU infants.
- To identify clinical and immunological factors associated with early or late seroreversion.
Main Methods:
- Longitudinal follow-up of HEU infants to determine time to seroreversion.
- Serological testing using enzyme-linked immunoabsorbent assay (ELISA) and Western blot (WB).
- Analysis of maternal and infant clinical and immunological data.
Main Results:
- Mean time to seroreversion by ELISA was 11.6 months (range 17.9-82.0 weeks) and by WB was 15.8 months (range 44.9-94.1 weeks).
- Higher initial anti-HIV antibody titers (cord blood ELISA OD) significantly correlated with longer time to seroreversion.
- No significant associations were found with gestational age, immunoglobulin levels, maternal CD4 counts, maternal alcohol use, or infant diarrhea/failure to thrive.
Conclusions:
- The extended time to seroreversion in HEU infants supports the accuracy of the 1994 CDC definition of HIV infection, which requires persistent seropositivity beyond 18 months.
- Recommend using Western blot for confirmatory testing of positive ELISAs only after 18 months of age in HEU infants.