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Has Highly Active Antiretroviral Therapy increased the time to seroreversion in HIV exposed but uninfected children?
MedLine Citation:
PMID:  22851494     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background. Since the introduction of highly active antiretroviral therapy (HAART) for prevention of mother to child transmission of HIV in pregnancy in the United States, the time of seroreversion in infants born to HIV-infected mothers has not been documented. The objective of this study was to determine the timing of clearance of HIV antibodies and to identify any associated biological and clinical factors.Methods. A retrospective analysis of infants who remained uninfected after perinatal HIV exposure was performed. Infant's and maternal medical records from January 2000 to December 2007 were reviewed and the time of seroreversion was estimated using methods for censored survival data.Results. In total, 744 infants were included in the study, with prenatal data available for 551 mothers. The median age of seroreversion was 13.9 months and 14% of infants remained seropositive after 18 months, 4.3% after 21months and 1.2% after 24 months. Earlier age of seroreversion was associated with higher immunoglobulin G (IgG) levels at 3-7 months of age (p= 0.0029) and a higher rate of IgG change over the next six months of life (p=0.003). Infants born by vaginal delivery were more likely to serorevert at a younger age (p=0.0052) and maternal exposure to protease inhibitor was associated with a later age of seroreversion (p=0.026).Conclusions. Clearance of HIV antibodies in uninfected infants was found to occur at a later age than previously reported. Fourteen percent of the infants had persistence of HIV antibodies at or beyond 18 months of age.
Authors:
Mavel Gutierrez; David A Ludwig; Safia S Khan; Aida A Chaparro; Delia M Rivera; Amanda M Cotter; Gwendolyn B Scott
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-31
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  -     ISSN:  1537-6591     ISO Abbreviation:  Clin. Infect. Dis.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-8-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Pediatrics, Division of Infectious Disease and Immunology, University of Miami- Miller School of Medicine. Miami, Florida. USA.
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