       Document 0325
 DOCN  M9460325
 TI    Human immunodeficiency virus infection in infants during the first 2
       months of life. Reliable detection and evidence of in utero
       transmission.
 DT    9404
 AU    Brandt CD; Rakusan TA; Sison AV; Saxena ES; Ellaurie M; Sever JL; Center
       for Virology, Immunology, and Infectious Diseases; Research, Children's
       Research Institute, Children's National; Medical Center, Washington, DC.
 SO    Arch Pediatr Adolesc Med. 1994 Mar;148(3):250-4. Unique Identifier :
       AIDSLINE MED/94177245
 AB    OBJECTIVE: To evaluate the clinical utility of a polymerase chain
       reaction (PCR) method for detecting human immunodeficiency virus (HIV)
       infection in infants 2 months of age or younger who were born to
       HIV-positive mothers. DESIGN: Prospective, longitudinal study lasting 3
       years. The PCR tests were performed with coded peripheral blood
       mononuclear cell lysates, and results were compared with findings using
       Centers for Disease Control and Prevention (CDC) (Atlanta, Ga) criteria
       defining HIV infection in children. SETTING: Hospitals, particularly a
       pediatric hospital in Washington, DC. PATIENTS: Newborns, young infants,
       and HIV-infected mothers. OUTCOME MEASURE: Presence or absence of
       pediatric HIV infection using CDC criteria compared with a diagnosis
       based on the detected presence or absence of HIV proviral DNA using PCR
       testing. RESULTS: One or more blood samples obtained by 62 days of age
       from 30 (94%) of 32 HIV-infected infants were positive for HIV by
       routine PCR testing. Blood samples from 32 infants now confirmed to be
       uninfected tested negative for HIV. Human immunodeficiency virus DNA was
       detected in blood samples obtained within 48 hours of birth from eight
       of nine infected infants. In six of these newborns as well as most older
       infants, HIV DNA was present in such quantity that it was detectable in
       specimens equivalent to 0.01 mL or less of the original blood sample.
       CONCLUSIONS: Our PCR procedure can reliably detect the presence or
       absence of HIV infection during the first 2 months of life. The frequent
       presence and not uncommon high titer of HIV DNA within 48 hours of birth
       suggest that much of the transmission of HIV from mother to infant
       occurs well before birth.
 DE    Age Factors  DNA, Viral/BLOOD  Female  Human  HIV/GENETICS  HIV
       Infections/BLOOD/*DIAGNOSIS/IMMUNOLOGY/MICROBIOLOGY/  TRANSMISSION
       Infant  Infant, Newborn  Longitudinal Studies  *Polymerase Chain
       Reaction  Prospective Studies  Reproducibility of Results  Sensitivity
       and Specificity  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

