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Predicting perinatal human immunodeficiency virus infection by antibody patterns
D Moodley1, R A Bobat, A Coutsoudis
1Department of Paediatrics and Child Health, Faculty of Medicine, University of Natal, Durban, South Africa.
Insights
Early detection of infant HIV-1 infection is possible by tracking antibody decay. Uninfected babies show rapid antibody titer decline, aiding early diagnosis and vertical transmission rate estimation.
Area of Science:
- Immunology
- Virology
- Pediatrics
Background:
- Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) remains a significant global health concern.
- Accurate and timely diagnosis of perinatal HIV-1 infection is crucial for initiating early treatment and improving outcomes.
- Standard diagnostic criteria often rely on prolonged observation periods, potentially delaying intervention.
Purpose of the Study:
- To investigate the longitudinal changes in HIV-1 antibody titers in infants born to HIV-1-seropositive mothers.
- To evaluate the utility of antibody decay patterns for early diagnosis of HIV-1 infection in infants.
- To assess the feasibility of using antibody decay for estimating vertical transmission rates.
Main Methods:
- Longitudinal study of 118 infants born to HIV-1-seropositive mothers in South Africa.
- Enzyme-linked immunosorbent assay (ELISA) used to determine HIV-1 antibody titers from birth to 18 months.
- Analysis of antibody decay rates in infected versus uninfected infants.
Main Results:
- By 18 months, 34.7% (41/118) of infants were diagnosed as HIV-1 infected.
- Uninfected infants (77) cleared maternal antibodies by 15 months, with 94.5% seroreverting by 12 months.
- A significant difference (P < 0.05) in antibody decay rates was observed by 9 months.
- Assessing antibody decay between 6 and 9 months showed high sensitivity (97.8%) and specificity (93.8%) for identifying uninfected infants.
Conclusions:
- Antibody decay rate analysis is a feasible and useful tool for diagnosing perinatal HIV-1 infection earlier than standard methods.
- This approach can aid in estimating vertical transmission rates more accurately.
- Monitoring antibody titer progression offers a promising strategy for early detection and management of HIV-1 in infants.
Abstract:
The evolution of human immunodeficiency virus type 1 (HIV-1) antibody titers determined by enzyme-linked immunosorbent assay between birth and 18 months of age was investigated in 118 babies born to HIV-1-seropositive South African mothers. By 18 months 41 (34.7%) children were diagnosed as HIV-1-infected by standard criteria. All 77 uninfected babies cleared maternal antibodies by 15 months; 94.5% of these babies seroreverted by 12 months. By 9 months of age a significant difference (P < 0.05) was noted between antibody decay rates in infected and uninfected children. Of the children subsequently shown to be uninfected, 95.8% demonstrated > or = 50% decay in antibody titers between 6 and 9 months; only 1 in the infected group showed a similar pattern (sensitivity, 97.8%; specificity, 93.8%). The approach of assessing the progression of antibody decay in infected and uninfected babies makes it a feasible and useful tool for estimating vertical transmission rates and diagnosis of perinatal HIV-1 infection earlier than standard practice.