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Viral Load as an HIV Test for Infants
Jul 14, 1998

My wife and I are trying to adopt a child. One particular child we have identified is an 11 week-old girl from a third world country. When she was taken to the orphanage at 4-5 weeks old, she was tested for HIV antibodies and was positive (level of 16 - don't know what test). We understand that this may not necessarily mean that she has HIV. Our doctors have said we should have a Viral Load (PCR)test conducted (and we are) to detect any levels of virus. My questions are this - if the viral load test comes back negative (or undetectable) does this mean she does not have the virus (and to what level of certainty)? Does it mean she will not develop the virus (and to what level of certainty)? I think it is safe to assume the mother had no treatment before or during pregnancy and the child has had none either. Also, it is unknown at what stage the mother was during pregnancy. Thanks you.

Response from Dr. Holodniy

Because of passive transfer of antibodies between mother and

fetus, newborn babies from HIV infected mothers can have a positive

HIV antibody test for months and not be infected. Most of the confusion

regarding HIV diagnosis in babies is in the first 4-8 weeks. Babies infected

in utero, will have positive viral load (PCR) tests, at birth, or shortly after. Babies

infected at the time of birth, or after, during breast feeding, may not have positive

viral load for a few weeks. In your case, a negative plasma HIV PCR viral load,

or negative cellular HIV DNA PCR test 12 weeks after birth, makes HIV infection

in the baby extremely unlikely.

MH



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