       Document 0635
 DOCN  M9640635
 TI    Detection of virus in vertically exposed HIV-antibody-negative children.
 DT    9604
 AU    Newell ML; Dunn D; De Maria A; Ferrazin A; De Rossi A; Giaquinto C; Levy
       J; Alimenti A; Ehrnst A; Bohlin AB; Ljung R; Peckham C; Institute of
       Child Health, London, UK.
 SO    Lancet. 1996 Jan 27;347(8996):213-5. Unique Identifier : AIDSLINE
       MED/96148717
 AB    BACKGROUND: HIV-infected mothers can transmit their infection to their
       children in utero or at delivery (vertical transmission). There have
       been cases of children who were reported as acquiring infection
       vertically and later clearing the infection. We report the frequency of
       this phenomenon in a European cohort study. METHODS: In four centres of
       the European Collaborative Study of children born to HIV-infected
       mothers, 299 children became HIV-antibody-negative and 264 of these had
       been followed up with virus culture and PCR for viral DNA at least once.
       FINDINGS: Nine of the 264 children were positive by virus culture or
       PCR, and subsequently seroreverted. Two of the nine tested
       virus-positive after they became antibody-negative. Six cases were
       virus-positive early in life and became negative thereafter, which is
       consistent with clearance of infection. The pattern was less clear in
       the other three. The nine cases had had their last virus test at age
       16-101 months. All nine children had been bottlefed only. Eight had been
       delivered vaginally. The children had no HIV-related symptoms and
       received no anti-HIV treatments. Based on only those children who had
       two or more positive virological tests, we estimate that 2.7% (6/219)
       cleared or tolerated the virus. INTERPRETATION: The detection of virus
       or viral DNA in uninfected children born to HIV-infected mothers was
       rare and was not associated with clinical disease or immunological
       abnormalities. The timing of samples will affect the documentation of
       clearance since, in uninfected children of HIV-positive mothers who
       cleared the virus, viraemia was intermittent. Current paediatric opinion
       is to inform parents of children who serorevert that the child is not
       HIV-infected.
 DE    Child, Preschool  Cohort Studies  *Disease Transmission, Vertical  DNA,
       Viral/ANALYSIS  Female  Human  HIV/GENETICS/*ISOLATION & PURIF  HIV
       Antibodies/ANALYSIS  HIV Infections/*TRANSMISSION  *HIV Seronegativity
       HIV Seropositivity  Infant  Infant, Newborn  Polymerase Chain Reaction
       Pregnancy  Pregnancy Complications, Infectious  CLINICAL TRIAL  JOURNAL
       ARTICLE  MULTICENTER STUDY

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

