Document 0526
 DOCN  M9480526
 TI    Sensitive detection and early prognostic significance of p24 antigen in
       heat-denatured plasma of human immunodeficiency virus type 1-infected
       infants. Swiss Neonatal HIV Study Group.
 DT    9410
 AU    Schupbach J; Boni J; Tomasik Z; Jendis J; Seger R; Kind C; Swiss
       National Center for Retroviruses, University of Zurich.
 SO    J Infect Dis. 1994 Aug;170(2):318-24. Unique Identifier : AIDSLINE
       MED/94308596
 AB    Immune complex formation causes underdetection of p24 antigen in human
       immunodeficiency virus (HIV) infection. Briefly boiling diluted plasma
       releases all complexed antigen, which can then be measured by some
       commercial assays. In a retrospective pediatric cohort study, the
       specificity of this procedure in 390 uninfected samples was 96.9% after
       initial testing and 100% after neutralization. Sensitivity among 125
       postnatal infected samples was, at a detection of 2 pg/mL, 96.0% (97%
       neutralizable) compared with 47.7% for regular antigen (76%
       neutralizable), 96% for polymerase chain reaction, and 77% for viral
       culture. The high sensitivity and specificity of heat-denatured antigen
       was confirmed by prospectively testing 113 additional samples.
       Quantitative analysis of samples from infected infants showed low levels
       of p24 antigen in 29% of cord blood sera, a postnatal increase to levels
       that were during the first 6 months of life inversely associated with
       survival, and persistence of antigenemia thereafter independent of
       clinical status. Prevalence and antigen levels were significantly lower
       in mothers. The persistent antigenemia in children indicates that their
       immune systems cannot restrict HIV expression as efficiently as those of
       adults.
 DE    Age Factors  Child  Child, Preschool  Cohort Studies  DNA,
       Viral/ANALYSIS  Female  Fetal Blood/IMMUNOLOGY  Follow-Up Studies  Heat
       Human  HIV Core Protein p24/*BLOOD  HIV
       Infections/*DIAGNOSIS/EPIDEMIOLOGY  HIV-1/GENETICS/*IMMUNOLOGY/ISOLATION
       & PURIF  Infant  Infant, Newborn  Male  Polymerase Chain Reaction
       Pregnancy  Pregnancy Complications, Infectious/DIAGNOSIS/EPIDEMIOLOGY
       Prevalence  Prognosis  Prospective Studies  Retrospective Studies
       Sensitivity and Specificity  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).