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newborn testing for hiv

May 28, 2005

My husband and I are in the process of adopting internationally. A waiting child has become available. She is approx 4 months at this time. Mother is hiv positive but the baby tested negative. They tested her x2 with dna pcr. How accurate is this testing with newborns and what, if any, are the long term concerns. Thanks

Response from Dr. Frascino


HIV DNA PCR is the preferred virologic method for diagnosing HIV during infancy. Clinical studies have shown that by age 28 days, HIV DNA PCR is 96% sensitive and 99% specific for identifying HIV proviral DNA. When two HIV DNA PCR assays are performed one month apart with one assay after four months of age, the sensitivity and specificity are both greater than 98%.

HIV DNA PCR is used rather than ELISA (antibody tests) because maternal anti-HIV antibodies can cross the placenta and consequently, infants born to HIV-positive moms can have positive ELISA and Western Blot tests even though these infants are themselves HIV-negative. Maternally derived antibodies can persist for up to 18 months.

At this point, the child you are considering adopting has an over 98% chance of being HIV negative. Should you adopt him or her, your pediatrician will probably run one more HIV test at the 18-month mark.

Good luck and congratulations!

Dr. Bob

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