VIROLOGICAL, IMMUNOLOGICAL, AND CLINICAL-EVALUATION OF HUMAN-IMMUNODEFICIENCY-VIRUS ANTIBODY STATUS OF SYMPTOM-FREE CHILDREN BORN TO INFECTED MOTHERS

Study objective: To determine the prevalence of infection by the human immunodeficiency virus (HIV) in a population of symptom-free children who were born to HIV-infected mothers and who subsequently underwent seroreversion from an HIV antibody-positive to an HIV antibody-negativ e status. Design: Cohort. Setting: Pediatric HIV program in a communit y setting. Patients: We used HIV DNA polymerase chain reaction (PCR) a nd coculture to detect the presence or absence of HIV in peripheral bl ood mononuclear cells of 134 children aged 6 to 53 months. All childre n had HIV antibody at birth and underwent a subsequent seroreversion t o antibody-negative status. Results: In 134 children with HIV antibody -negative status, 219 of 220 culture results and 242 of 247 HIV-1 DNA PCR assay results were negative. Six positive laboratory results were obtained for six different children, each of whom had negative results on multiple assays. For HIV-infected children, 56 of 62 cultures and 99 of 104 PCR evaluations showed positive results. There was no clinic al or laboratory evidence of HIV infection in the group with HIV antib ody-negative status. Conclusion: We were unable to find evidence of la tent HIV type 1 infection in this cohort of symptom-free children who underwent seroreversion to HIV antibody-negative status. The loss of m aternal HIV antibody in these children indicates the absence of HIV in fection. False-positive PCR and culture results occurred sporadically, indicating that repeated analysis of HIV seropositivity in infants an d children is necessary.