False-negative post-18-month confirmatory HIV tests in HIV DNA PCR-positive children: a retrospective analysis
The WHO guidelines for children less than 18 months old diagnosed with HIV based on presumptive clinical diagnosis or one virologic test recommend confirmatory HIV antibody testing after 18 months of age. This study describes post-18-month HIV test results following this WHO-recommended confirmatory...
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| Veröffentlicht in: | AIDS (London) 2012-09, Vol.26 (15), p.1927-1934 |
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| container_title | AIDS (London) |
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| creator | GARCIA-PRATS, Anthony J DRAPER, Heather R SANDERS, Jill E AGRAWAL, Anurag K MOHAPI, Edith Q SCHUTZE, Gordon E |
| description | The WHO guidelines for children less than 18 months old diagnosed with HIV based on presumptive clinical diagnosis or one virologic test recommend confirmatory HIV antibody testing after 18 months of age. This study describes post-18-month HIV test results following this WHO-recommended confirmatory testing strategy.
Case series and retrospective review of routine program data.
Children enrolled at the Baylor Children's Clinical Center of Excellence, a pediatric and family HIV clinic in Maseru, Lesotho from December 2005 through January 2009 with a positive HIV DNA PCR at less than 18 months of age and HIV rapid test results after 18 months of age were included. Post-18-month confirmatory HIV test results are described. Factors associated with non-positive confirmatory rapid tests were determined using binary logistic regression.
Of the 109 children meeting inclusion criteria, 22 (20.2%) had negative and 27 (24.8%) discordant confirmatory rapid tests. Forty-six of these 49 were on antiretroviral therapy (ART). Among these 49, 11 of 24 post-18-month HIV DNA PCRs were negative, whereas nine of 10 post-18-month HIV ELISAs were positive; 29 were definitively and 17 probably HIV-infected, two were uninfected, and one had undetermined status. Only age less than 9 months at ART initiation (odds ratio 4.25, P = 0.002) was associated with non-positive rapid tests.
False-negative post-18-month confirmatory rapid tests and HIV DNA PCRs in children on ART are common, associated with early ART initiation, and may lead to inappropriate ART discontinuation and discharge from care of truly HIV-infected children. |
| doi_str_mv | 10.1097/QAD.0b013e32835705bf |
| format | Article |
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Case series and retrospective review of routine program data.
Children enrolled at the Baylor Children's Clinical Center of Excellence, a pediatric and family HIV clinic in Maseru, Lesotho from December 2005 through January 2009 with a positive HIV DNA PCR at less than 18 months of age and HIV rapid test results after 18 months of age were included. Post-18-month confirmatory HIV test results are described. Factors associated with non-positive confirmatory rapid tests were determined using binary logistic regression.
Of the 109 children meeting inclusion criteria, 22 (20.2%) had negative and 27 (24.8%) discordant confirmatory rapid tests. Forty-six of these 49 were on antiretroviral therapy (ART). Among these 49, 11 of 24 post-18-month HIV DNA PCRs were negative, whereas nine of 10 post-18-month HIV ELISAs were positive; 29 were definitively and 17 probably HIV-infected, two were uninfected, and one had undetermined status. Only age less than 9 months at ART initiation (odds ratio 4.25, P = 0.002) was associated with non-positive rapid tests.
False-negative post-18-month confirmatory rapid tests and HIV DNA PCRs in children on ART are common, associated with early ART initiation, and may lead to inappropriate ART discontinuation and discharge from care of truly HIV-infected children.</description><identifier>ISSN: 0269-9370</identifier><identifier>EISSN: 1473-5571</identifier><identifier>DOI: 10.1097/QAD.0b013e32835705bf</identifier><identifier>PMID: 22739392</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>AIDS/HIV ; Anti-HIV Agents - administration & dosage ; Biological and medical sciences ; DNA, Viral - genetics ; DNA, Viral - isolation & purification ; Drug Administration Schedule ; False Negative Reactions ; Female ; HIV - genetics ; HIV Antibodies - genetics ; HIV Seropositivity - diagnosis ; HIV Seropositivity - drug therapy ; HIV Seropositivity - epidemiology ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infant ; Infant, Newborn ; Infectious diseases ; Lesotho - epidemiology ; Male ; Medical sciences ; Nucleic Acid Amplification Techniques ; Polymerase Chain Reaction - methods ; Reagent Kits, Diagnostic ; Reproducibility of Results ; Retrospective Studies ; Time Factors ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>AIDS (London), 2012-09, Vol.26 (15), p.1927-1934</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c319t-a13c25cb0b72065dcf72ac3891d90811116e1bb4205fcc29829fa8a04242dca13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26403803$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22739392$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>GARCIA-PRATS, Anthony J</creatorcontrib><creatorcontrib>DRAPER, Heather R</creatorcontrib><creatorcontrib>SANDERS, Jill E</creatorcontrib><creatorcontrib>AGRAWAL, Anurag K</creatorcontrib><creatorcontrib>MOHAPI, Edith Q</creatorcontrib><creatorcontrib>SCHUTZE, Gordon E</creatorcontrib><title>False-negative post-18-month confirmatory HIV tests in HIV DNA PCR-positive children: a retrospective analysis</title><title>AIDS (London)</title><addtitle>AIDS</addtitle><description>The WHO guidelines for children less than 18 months old diagnosed with HIV based on presumptive clinical diagnosis or one virologic test recommend confirmatory HIV antibody testing after 18 months of age. This study describes post-18-month HIV test results following this WHO-recommended confirmatory testing strategy.
Case series and retrospective review of routine program data.
Children enrolled at the Baylor Children's Clinical Center of Excellence, a pediatric and family HIV clinic in Maseru, Lesotho from December 2005 through January 2009 with a positive HIV DNA PCR at less than 18 months of age and HIV rapid test results after 18 months of age were included. Post-18-month confirmatory HIV test results are described. Factors associated with non-positive confirmatory rapid tests were determined using binary logistic regression.
Of the 109 children meeting inclusion criteria, 22 (20.2%) had negative and 27 (24.8%) discordant confirmatory rapid tests. Forty-six of these 49 were on antiretroviral therapy (ART). Among these 49, 11 of 24 post-18-month HIV DNA PCRs were negative, whereas nine of 10 post-18-month HIV ELISAs were positive; 29 were definitively and 17 probably HIV-infected, two were uninfected, and one had undetermined status. Only age less than 9 months at ART initiation (odds ratio 4.25, P = 0.002) was associated with non-positive rapid tests.
False-negative post-18-month confirmatory rapid tests and HIV DNA PCRs in children on ART are common, associated with early ART initiation, and may lead to inappropriate ART discontinuation and discharge from care of truly HIV-infected children.</description><subject>AIDS/HIV</subject><subject>Anti-HIV Agents - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>DNA, Viral - genetics</subject><subject>DNA, Viral - isolation & purification</subject><subject>Drug Administration Schedule</subject><subject>False Negative Reactions</subject><subject>Female</subject><subject>HIV - genetics</subject><subject>HIV Antibodies - genetics</subject><subject>HIV Seropositivity - diagnosis</subject><subject>HIV Seropositivity - drug therapy</subject><subject>HIV Seropositivity - epidemiology</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infectious diseases</subject><subject>Lesotho - epidemiology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nucleic Acid Amplification Techniques</subject><subject>Polymerase Chain Reaction - methods</subject><subject>Reagent Kits, Diagnostic</subject><subject>Reproducibility of Results</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>0269-9370</issn><issn>1473-5571</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctOxCAUhonR6Hh5A2O6MXGDHqAUcDcZr4nxFnXbUEoV09IROibz9uI4auJGNoSc7-Ockx-hXQKHBJQ4uhufHEIFhFlGJeMCeNWsoBHJBcOcC7KKRkALhRUTsIE2Y3wFAA5SrqMNSgVTTNER8me6jRZ7-6wH926zaR8HTCTuej-8ZKb3jQudHvowzy4un7LBxiFmzi8eJ9fj7HZyj5PjFrJ5cW0drD_OdBbsEPo4tWZR0V638-jiNlprPhvuLO8t9Hh2-jC5wFc355eT8RU2jKgBa8IM5aaCSlAoeG0aQbVhUpFagSTpFJZUVU6BN8ZQJalqtNSQ05zWJtlb6ODr32no32Zp6LJz0di21d72s1gSQjllBRfF_ygUKg0hlUho_oWatFoMtimnwXU6zBNUfoZSplDKv6EkbW_ZYVZ1tv6RvlNIwP4S0NHotgnaGxd_uSIHJoGxD4C1lK8</recordid><startdate>20120924</startdate><enddate>20120924</enddate><creator>GARCIA-PRATS, Anthony J</creator><creator>DRAPER, Heather R</creator><creator>SANDERS, Jill E</creator><creator>AGRAWAL, Anurag K</creator><creator>MOHAPI, Edith Q</creator><creator>SCHUTZE, Gordon E</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>7TM</scope><scope>7U9</scope><scope>H94</scope></search><sort><creationdate>20120924</creationdate><title>False-negative post-18-month confirmatory HIV tests in HIV DNA PCR-positive children: a retrospective analysis</title><author>GARCIA-PRATS, Anthony J ; DRAPER, Heather R ; SANDERS, Jill E ; AGRAWAL, Anurag K ; MOHAPI, Edith Q ; SCHUTZE, Gordon E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c319t-a13c25cb0b72065dcf72ac3891d90811116e1bb4205fcc29829fa8a04242dca13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>AIDS/HIV</topic><topic>Anti-HIV Agents - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>DNA, Viral - genetics</topic><topic>DNA, Viral - isolation & purification</topic><topic>Drug Administration Schedule</topic><topic>False Negative Reactions</topic><topic>Female</topic><topic>HIV - genetics</topic><topic>HIV Antibodies - genetics</topic><topic>HIV Seropositivity - diagnosis</topic><topic>HIV Seropositivity - drug therapy</topic><topic>HIV Seropositivity - epidemiology</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infectious diseases</topic><topic>Lesotho - epidemiology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Nucleic Acid Amplification Techniques</topic><topic>Polymerase Chain Reaction - methods</topic><topic>Reagent Kits, Diagnostic</topic><topic>Reproducibility of Results</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>GARCIA-PRATS, Anthony J</creatorcontrib><creatorcontrib>DRAPER, Heather R</creatorcontrib><creatorcontrib>SANDERS, Jill E</creatorcontrib><creatorcontrib>AGRAWAL, Anurag K</creatorcontrib><creatorcontrib>MOHAPI, Edith Q</creatorcontrib><creatorcontrib>SCHUTZE, Gordon E</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>AIDS (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>GARCIA-PRATS, Anthony J</au><au>DRAPER, Heather R</au><au>SANDERS, Jill E</au><au>AGRAWAL, Anurag K</au><au>MOHAPI, Edith Q</au><au>SCHUTZE, Gordon E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>False-negative post-18-month confirmatory HIV tests in HIV DNA PCR-positive children: a retrospective analysis</atitle><jtitle>AIDS (London)</jtitle><addtitle>AIDS</addtitle><date>2012-09-24</date><risdate>2012</risdate><volume>26</volume><issue>15</issue><spage>1927</spage><epage>1934</epage><pages>1927-1934</pages><issn>0269-9370</issn><eissn>1473-5571</eissn><abstract>The WHO guidelines for children less than 18 months old diagnosed with HIV based on presumptive clinical diagnosis or one virologic test recommend confirmatory HIV antibody testing after 18 months of age. This study describes post-18-month HIV test results following this WHO-recommended confirmatory testing strategy.
Case series and retrospective review of routine program data.
Children enrolled at the Baylor Children's Clinical Center of Excellence, a pediatric and family HIV clinic in Maseru, Lesotho from December 2005 through January 2009 with a positive HIV DNA PCR at less than 18 months of age and HIV rapid test results after 18 months of age were included. Post-18-month confirmatory HIV test results are described. Factors associated with non-positive confirmatory rapid tests were determined using binary logistic regression.
Of the 109 children meeting inclusion criteria, 22 (20.2%) had negative and 27 (24.8%) discordant confirmatory rapid tests. Forty-six of these 49 were on antiretroviral therapy (ART). Among these 49, 11 of 24 post-18-month HIV DNA PCRs were negative, whereas nine of 10 post-18-month HIV ELISAs were positive; 29 were definitively and 17 probably HIV-infected, two were uninfected, and one had undetermined status. Only age less than 9 months at ART initiation (odds ratio 4.25, P = 0.002) was associated with non-positive rapid tests.
False-negative post-18-month confirmatory rapid tests and HIV DNA PCRs in children on ART are common, associated with early ART initiation, and may lead to inappropriate ART discontinuation and discharge from care of truly HIV-infected children.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>22739392</pmid><doi>10.1097/QAD.0b013e32835705bf</doi><tpages>8</tpages></addata></record> |
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| ispartof | AIDS (London), 2012-09, Vol.26 (15), p.1927-1934 |
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| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | AIDS/HIV Anti-HIV Agents - administration & dosage Biological and medical sciences DNA, Viral - genetics DNA, Viral - isolation & purification Drug Administration Schedule False Negative Reactions Female HIV - genetics HIV Antibodies - genetics HIV Seropositivity - diagnosis HIV Seropositivity - drug therapy HIV Seropositivity - epidemiology Human immunodeficiency virus Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infant Infant, Newborn Infectious diseases Lesotho - epidemiology Male Medical sciences Nucleic Acid Amplification Techniques Polymerase Chain Reaction - methods Reagent Kits, Diagnostic Reproducibility of Results Retrospective Studies Time Factors Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | False-negative post-18-month confirmatory HIV tests in HIV DNA PCR-positive children: a retrospective analysis |
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