Abstract
HIV infection in infants is usually documented by the presence of serum Ab to the virus. Individuals who are persistently viremic but without detectable serum Ab have been reported. A 4 month old infant of a parenteral drug abuser presented with failure to thrive, generalized lymphadenopathy and hepatosplenomegaly; at 6 mos of age Pneumocystis carinii pneumonitis developed. Initial evaluation (age 4 mos) revealed polyclonal hypergammaglobulinemia, T4/Tg = 1.5 and absolute lymphocyte count = 6460/mm3. Results of longitudinal serological evaluations are summarized in the table.
This prolonged high grade antigenemia in the presence of low levels of specific Ab is analogous to the phenomenon of pseudotolerance observed in congenital rubella and cytomegalovirus infections and suggests that this infant was infected in utero. In infants at risk for HIV infection Ab assays alone may prove to be inadequate for diagnosis. Viral isolation and/or HIV Ag detection techniques are important tools in such situations.
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Krilov, L., Kamanl, N., Hendry, R. et al. LONGITUDINAL EVALUATION OF A HUMAN IMMUNODEFICIENCY VIRUS (HIV) POSITIVE, ANTIBODY (AB) NEGATIVE INFANT WITH AIDS. Pediatr Res 21 (Suppl 4), 328 (1987). https://doi.org/10.1203/00006450-198704010-00965
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DOI: https://doi.org/10.1203/00006450-198704010-00965