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Will my foster son seroconvert?
Nov 26, 2003

I am in the process of adopting my foster son (now 10 and a half months old). I received him from the hospital at 6 days old. He was the child of a crack using prostitute. I asked about his HIV status. They said he tested negative (at 2 days old). So, to be safe, I got a court order for the pediatrician to test him again. They did the second testing at 6 and a half months old. Both tests were non-reactive. However, I was recently informed that his bio-mother has tested positive for HIV. I do not know when she contracted it or when she seroconverted. I don't know if she already had it when she was pregnant. So, I started researching the testing done on the baby. The tests were "HIV-1 AB screen with refl" tests. I am assuming these are the ELISA tests(???) But, after researching the internet, I have read that the PCR would tell me his true status. I am confused because I thought he would have tested positive due to her antibodies at the initial screening he went through at birth if she already had it herself. But, he tested negative. He has had a bout of pneumonia (I don't know which kind) at 3 weeks of age, and he is under the 5th percentile for height and weight. So,since these could be indicators of HIV, my doctor said we should wait until he is 15-18 months old and retest him. She said he could still convert. I thought that the two negative screenings (one after a 6 month window) would clear him. Now I am so worried. She said the chances of the seroconversion are less than 1, but this child has had everything against him since birth. I was initially under the impression that once an infant over 6 months of age tests negative (ELISA?), then he is cleared. Is this not true? Should I get that PCR test? Please answer my questions. I am so worried for this little boy. Thank you.

Response from Dr. Sullivan

The sequence and the type of tests that were performed on your child indicate that he is not infected with HIV; the negative antibody test at birth means that his biological mother was not infected at the time of his birth unless she was infected in the last 3 weeks of pregnancy which is highly unlikely; the followup testing of your child at 6.5 months of age absolutely confirms that he is not infected; no further testing of any type for HIV is necessary; JLS.

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