The Utility of IgA Antibody to Human Immunodeficiency Virus Type 1 in Early Diagnosis of Vertically Transmitted Infection
Kenneth McIntosh, MD;
Anne Marie Comeau, PhD;
Diane Wara, MD;
Clemente Diaz, MD;
Sheldon Landesman, MD;
Jane Pitt, MD;
Kenneth Rich, MD;
Judy Lew, MD;
Jack Moye, MD;
Leslie A. Kalish, DSc
Arch Pediatr Adolesc Med. 1996;150(6):598-602.
Abstract
Objective
To determine the sensitivity and specificity of anti–human immunodeficiency virus (HIV) IgA in identifying infected infants at or before 6 months of age among the offspring of HIV-infected mothers.
Design
Prospective comparison of anti-HIV IgA measurement performed in 2 different laboratories by 2 different methods with the criterion standard of blood culture.
Setting
Five centers in the United States and Puerto Rico.
Patients
Population-based sample of 156 infants of HIV-infected mothers in the Women and Infants Transmission Study.
Main Outcome Measures
Results of anti-HIV IgA test in relation to the infection status of the infants as measured by blood culture.
Results
Six-month plasma or serum samples were first tested in the 2 laboratories. The sensitivity and specificity of anti-HIV IgA in detecting infected infants at this age by laboratories 1 and 2 were 69% and 63% and 100% and 99%, respectively. A look-back study of samples obtained at birth, 1, 2, and 4 months was then performed on all infected children and a matched set of uninfected children. The performance of the test at birth was unsatisfactory in both laboratories (sensitivity 44% and 33%, specificity 43% and 60%), whether peripheral or cord blood was examined. At 1, 2, and 4 months, the sensitivity of the test was lower than at 6 months, but specificity was high. A modest correlation of absent anti-HIV IgA antibody and low percentage of CD4 cells in peripheral blood was seen at 6 months of age.
Conclusions
The anti-HIV IgA test has moderate sensitivity and high specificity for the diagnosis of HIV infection at 6 months of age in the offspring of infected mothers.
(Arch Pediatr Adolesc Med. 1996;150:598-602)
Author Affiliations
The affiliations of the authors appear in the acknowledgment section at the end of the article.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
IgA ANTIBODIES TO DETECT HIV IN INFANTS
JWatch General 1996;1996:5-5.
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