Document 2653
 DOCN  M94A2653
 TI    Laboratory diagnosis of HIV infection in children born to HIV women in
       Chile.
 DT    9412
 AU    Munoz G; Ramirez E; Ojeda M; Child R; National Comission of AIDS Chile.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):255 (abstract no. PB0451). Unique
       Identifier : AIDSLINE ICA10/94369922
 AB    INTRODUCTION: The opportune and reliable laboratory diagnosis of HIV
       infection is a fundamental tool for the prognosis and treatment of
       children born to sero-positive mothers. Laboratory diagnosis in these
       patients represents a major challenge because of transplacentary
       transmission of maternal HIV-Antibodies (Ab.). Since 1987, a total of 85
       children born to HIV (+) women has been notified and submitted to a
       National Surveillance Programme developed by the National Commission of
       AIDS (CONASIDA), the Pediatric AIDS National Committee and the National
       Reference Laboratory of AIDS (CNRS). This Programme includes a
       well-defined follow-up protocol for HIV laboratory diagnosis for all the
       children born to sero-positive mothers. A special algorythm has been
       established for these cases including the provirus detection by
       Polymerase Chain Reaction (PCR). OBJECTIVE: To asses the results
       obtained from the National Surveillance Programme for laboratory
       diagnosis of HIV status in children born to HIV (+) women in Chile.
       PATIENTS/METHODS: A total of 85 children were studied since 1987 to Jan.
       1994, representing all the known cases of newborns from HIV (+) mothers
       all over the country. Serial blood samples were taken at birth, 3, 6, 9,
       12, 15, 18 and 24 months. Each sample was tested for HIV-Ab (ELISA) and
       supplementary tests (IFA, WB and/or Lia-Tek), P-24 Antigen (ELISA) and
       provirus detection in PBMC (PCR) at the CNRS. Positive results for P-24
       and/or PCR in two serial samples at any age or persistence of HIV-Ab
       after aged 15 months was considered as positive infection. Indeterminate
       cases were defined as (+) HIV-Ab and P-24 and PCR negative results in
       children under 15 months. RESULTS: From 85 children submitted to
       follow-up, 20 (24%) were confirmed as HIV (+). Thirty three children
       were negative (39%) and 32 (37%) are still Indeterminate. Half of
       negatives cases lost their Abs. between 6-12 months (54%). One child was
       negative between 3-6 months of age. Positive Ag. and/or PCR results were
       mostly found between 9 and 12 months. One child was positive at one
       month by PCR and another at three months by Ag. CONCLUSIONS: Pediatric
       AIDS is an emerging problem in Chile, with 12 notified cases up to
       January 1994; 75% of them has already died. National Surveillance
       Programme, follow-up testing and the development of a special algorythm
       has led to an opportune, reliable and accesible HIV laboratory diagnosis
       for children born to HIV (+) women in Chile. Vertical transmission have
       been demonstrated in 24% of this cases. This Programme has allowed an
       increase in the diagnosis precocity, a decrease in psychoaffective
       problems and a better preventive and therapeutic treatment.
 DE    *AIDS Serodiagnosis  Blotting, Western  Child, Preschool  Chile
       *Developing Countries  Enzyme-Linked Immunosorbent Assay  Female
       Follow-Up Studies  Human  HIV Antibodies/BLOOD  HIV Core Protein
       p24/IMMUNOLOGY  HIV Infections/*DIAGNOSIS/IMMUNOLOGY/TRANSMISSION
       Infant  Infant, Newborn  Male  Polymerase Chain Reaction  Predictive
       Value of Tests  Pregnancy  MEETING ABSTRACT

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