BLOOD CULTURE IN THE FIRST 6 MONTHS OF LIFE FOR THE DIAGNOSIS OF VERTICALLY TRANSMITTED HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Serial blood cultures over the first 6 months of life in 310 infants w ith vertical exposure to human immunodeficiency virus (HIV) in the Wom en and Infants Transmission Study were analyzed to determine their val ue for early diagnosis of HIV infection. Cultures were done at 0-7 day s and 1, 2, 4, and 6 months of age: 55 infants were infected. Blood cu lture sensitivity in infected children was 24% (7/29) during the first week of life and 85%, 91%, 82%, and 88%, respectively, at 1, 2, 4, an d 6 months. The sensitivity, specificity, and positive and negative pr edictive values of a single culture between 1 and 6 months of age were , respectively, 86.9%, 99.6%, 97.9%, and 97.5%. Two negative cultures between 1 and 6 months of age defined an uninfected infant with a spec ificity of 99.2%-100.0%. Blood culture done between 1 and 6 months of age in children of HIV-positive mothers is a sensitive and specific te st for HIV infection, with high positive and negative predictive value s.