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Adopting Child with initial positive then negative tests
Apr 14, 2006

We are considering adopting a child with the following results: 02/04 born;04/04 negative PCR HIV;07/04 negative PCR HIV;09/04 positive EIA to HIV;12/04 negative EIA to HIV;08/05 hiv monitoring stopped. What does it all mean?

Response from Dr. Luzuriaga

An EIA (enzyme immunoassay) detects antibodies (an immune response) to HIV while the PCR (polymerase chain reaction) is a test that detects HIV genetic material (DNA or RNA).

All HIV infected women have HIV antibodies and are EIA positive. During the last 3 months of pregnancy, women pass all of their antibodies (including antibodies to HIV) to their babies. However, only 25-30% pass the virus to their babies in the absence of antiviral therapy. If moms and babies receive antiviral therapy, transmission rates are much lower.

Since mothers pass antibodies to their babies and it may take up to 24 months for the babies to clear the antibodies, antibody tests (such as the EIA) can not be used to diagnose infection in young babies. We use the PCR test instead to look for pieces of viral DNA or RNA in the babies' blood. With two negative PCR tests (at 2 and 5 months of age), your baby is uninfected. This was confirmed by looking for disappearance of the antibodies from the baby's blood (negative EIA at 10 months of age).


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