Document 0605
 DOCN  M95A0605
 TI    HIV-specific IgA in infants born to HIV seropositive women. American
       Pediatric Society 104th annual meeting and Society for Pediatric
       Research 63rd annual meeting; 1994 May 2-5; Seattle.
 DT    9510
 AU    Livingston RA; Hutton N; Halsey NA; Kline RL; Joyner M; Butz A; Quinn
       TC; Department of Pediatrics, Johns Hopkins Univeristy, Baltimore,; USA.
 SO    Pediatr AIDS HIV Infect. 1994 Oct;5(5):321 (unnumbered abstract). Unique
       Identifier : AIDSLINE AIDS/95330439
 AB    OBJECTIVES: To determine the sensitivity and specificity of HIV-specific
       IgA in the diagnosis of vertically-transmitted HIV infection including
       the first month of life. DESIGN/PATIENTS: Prospective cohort study of
       117 infants born to HIV-seropositive women in a teaching hospital
       serving a large urban center, and 192 older infants and children
       referred for diagnosis and treatment of HIV infection. OUTCOME MEASURES:
       Results from HIV-IgA immunoblot assays were compared with the eventual
       infection status of patients as determined by Centers for Disease
       Control criteria or by use of early diagnostic assays for HIV at
       sequential clinical visits. Sensitivity, specificity, and predictive
       values were calculated for each age range. RESULTS: The sensitivity of
       the HIV-specific IgA test during the first month of life was 3 of 24
       (12.5%) and the specificity was 65 of 73 (89.0%). The sensitivity
       progressively increased to 61.3% at 3-5 months of age and 94.7% at 9-11
       months of age. After the first month of life only three false positive
       results occurred in 311 specimens from 176 uninfected children. The
       positive predictive value of this assay was 27.3% for neonates, but was
       99.0% after the first month of life. The negative predictive value was
       78.8% before 3 months, 76.9% at 3-5 months, and 95.4% after 6 months of
       age. CONCLUSION: In the first month of life, false positive tests for
       HIV-specific IgA occurred commonly, presumably because of the presence
       of maternal IgA in the neonatal circulation. Detection of HIV-IgA is
       highly specific after one month of age and provides useful information.
       The test is most sensitive after 6 months of age. These results suggest
       that the majority of maternal-fetal transmission of HIV occurs shortly
       before or at the time of parturition.
 DE    *Antibody Specificity  Cohort Studies  *Disease Transmission, Vertical
       Female  Human  HIV Antibodies/*ANALYSIS  HIV
       Infections/*DIAGNOSIS/IMMUNOLOGY/TRANSMISSION  *HIV Seropositivity
       IgA/*ANALYSIS  Immunoblotting  Infant  Infant, Newborn  Predictive Value
       of Tests  Pregnancy  *Pregnancy Complications, Infectious  Prospective
       Studies  Sensitivity and Specificity  Support, U.S. Gov't, P.H.S.
       MEETING ABSTRACT  JOURNAL ARTICLE

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