RETROVIRAL ANTIGENEMIA IN CHILDREN WITH HIV INFECTION

Abstract

A selected group of 16 children with suspected or documented infection with the Human Immunodeficiency Virus (HIV) were tested for HIV antigen using an ELISA antigen capture assay. Fifteen were antigen positive at some time in their life. Two of these 15 children had immunologic abnormalities but were consistently HIV antibody negative (HIV Ab−). Five of the children were tested during the neonatal period and subsequently for 4-10 months. All 5 are HIV Ab+ but immunologically and clinically well to date. Three of the 5 were HIV antigen negative (HIV Ag−) at birth but 2 have since become HIV antigen positive (HIV Ag+). Two of the 5 were HIV Ag+ at birth but one is HIV Ag− after 8 months. Two HIV Ab+ Ag− mothers produced children who were HIV Ag+ at birth. Two HIV Ab+ Ag+ mothers produced children who were HIV Ag− at birth. Thus HIV antigen need not passively cross the placenta as does HIV antibody. Two sets of HIV Ab+ twins were also HIV Ag+. One of each set of twins developed severe HIV-related illness in the 1st 4 months of life. Within each set, the affected twin had the higher titre of antigen. Measurement of HIV antigen may be useful in evaluating the presence of HIV infection in the first months of life, irrespective of their HIV antibody status, particularly when repeated at regular intervals.