HIV-1 ICD p24 antigen detection in Ugandan infants: Use in early diagnosis of infection and as a marker of disease progression

Laura A. Guay, David L. Hom, Sam R. Kabengera, Estelle M. Piwowar-Manning, Peter Kataaha, Christopher Ndugwa, Lawrence H. Marum, Israel Kalyesubula, J. Brooks Jackson

Research output: Contribution to journalArticlepeer-review

Abstract

The objective of this study was to determine the use of immune-complex dissociated (ICD) p24 antigen detection for the diagnosis and prognosis of HIV-1 infection in Ugandan children. Plasma collected prospectively from children born to HIV-1 infected Ugandan women was stored and later analyzed for the presence of neutralizable HIV-1 p24 antigen using the Coulter ICD p24 antigen and neutralization kits. HIV-1 infection status, disease progression, and survival of the children were determined. Specimens from 311 children born to HIV-1 infected women, including 138 HIV-1 infected children, and 113 children born to negative women were tested. Sixty-nine (50%) infected children were p24 antigen positive at least once. For early HIV-1 diagnosis, the specificity and positive predictive value of the assay were consistently high (>95% and >83% respectively), but the sensitivity was low (6-53%), especially in the first months of life. The presence of p24 antigenemia in the first two years of life was associated with poor survival (20%) by 80 months of age compared with infected children without antigenemia (43%, P <0.001). Early detection of p24 antigen (≤2 months) was associated with higher mortality than first detection at an older age (>6 months, P <0.001). The data suggest that ICD p24 antigen detection is not a sensitive method for the determination of infant HIV-1 status in our cohort of HIV-1 infected Ugandan children tested in the first two years of life. There was a strong correlation, however, between the presence and time of onset of p24 antigenemia and mortality among HIV-1 infected children. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish (US)
Pages (from-to)426-434
Number of pages9
JournalJournal of Medical Virology
Volume62
Issue number4
DOIs
StatePublished - 2000

Keywords

  • Africa
  • Disease progression
  • Early diagnosis
  • HIV
  • p24 antigen
  • Pediatrics

ASJC Scopus subject areas

  • Virology

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