Young age at start of antiretroviral therapy and negative HIV antibody results in HIV-infected children when suppressed.
AIDS
; 29(9): 1053-60, 2015 Jun 01.
Article
in En
| MEDLINE
| ID: mdl-25870988
BACKGROUND: Negative results on standard HIV antibody tests have been described among HIV-infected children suppressed on antiretroviral therapy (ART) started early in life. Here, we describe the frequency and predictors of this phenomenon in a well characterized cohort of treated children. METHODS: We selected samples from 103 HIV-infected children who started ART 14 months of age or less and from 122 children who started 6 months of age or less followed as part of two sequential clinical trials in Johannesburg, South Africa. Children had attained viral suppression on ART and had received ART for between 3 and 6.4 years (mean 4.3 years) when tested for HIV antibody using a standard ELISA (Genescreen HIV1/2 version 2; Bio-rad). RESULTS: Only children 6 months of age or less when ART was started had negative antibody results when tested after suppression on ART several years later. Negative or low-positive antibody results were observed in 40.0, 37.0 and 27.8% of children starting ART less than 2 months of age, or starting during month 2 or 3, respectively. This dropped to 5.9, 3.5 and 5.3% if ART was started during month 4, 5 and 6, respectively. Higher CD4 percentage prior to ART initiation and no recorded intermittent viremia also predicted negative antibody results. CONCLUSION: Testing negative on standard HIV antibody tests occurs fairly commonly among HIV-infected children who started ART 3 months of age or less and are virally suppressed. It would be prudent in clinical practice to avoid HIV antibody tests among virally suppressed, early-treated children to prevent unnecessary confusion.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Antibodies
/
HIV Infections
/
Antiretroviral Therapy, Highly Active
/
Anti-Retroviral Agents
Type of study:
Prognostic_studies
Limits:
Child
/
Child, preschool
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Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
Africa
Language:
En
Journal:
AIDS
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2015
Document type:
Article
Affiliation country:
Country of publication: