Book contents
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- 1 Normal development and physiology of the immune system
- 2 HIV basic virology for clinicians
- 3 The immunology of pediatric HIV disease
- 4 The clinical virology of pediatric HIV disease
- 5 The natural history of pediatric HIV disease
- 6 The epidemiology of pediatric HIV disease
- Part II General issues in the care of pediatric HIV patients
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
4 - The clinical virology of pediatric HIV disease
from Part I - Scientific basis of pediatric HIV care
Published online by Cambridge University Press: 03 February 2010
- Frontmatter
- Contents
- List of contributors
- List of abbreviations
- Foreword
- Preface
- Introduction
- Part I Scientific basis of pediatric HIV care
- 1 Normal development and physiology of the immune system
- 2 HIV basic virology for clinicians
- 3 The immunology of pediatric HIV disease
- 4 The clinical virology of pediatric HIV disease
- 5 The natural history of pediatric HIV disease
- 6 The epidemiology of pediatric HIV disease
- Part II General issues in the care of pediatric HIV patients
- Part III Antiretroviral therapy
- Part IV Clinical manifestations of HIV infection in children
- Part V Infectious problems in pediatric HIV disease
- Part VI Medical, social, and legal issues
- Appendices
- Index
- Plate section
- References
Summary
The advent of potent antiretroviral therapy and effective prophylaxis for opportunistic infections has created a clear need for early diagnosis of HIV infection in pediatric patients and for methods of monitoring disease course and response to therapy. The field has undergone substantial progress within the past decade and innovations continue to emerge. Diagnostic issues will be addressed initially in this chapter, followed by virologic approaches for monitoring disease course and response to therapy.
Virologic assays for the diagnosis of pediatric HIV infection
Serology
Reports of the isolation of a human immunodeficiency virus (LAV; HTLV-III; later to be known as HIV-1) in 1984 [1–4] were quickly followed by the development of enzyme immunoassays (EIAs) capable of detecting a human antibody response to infection [5, 6]. It soon became clear that reactive EIAs required confirmation by Western blot to verify that the EIA-detected immune response was HIV-specific. While confirmation is essential for all EIA-reactive specimens, it is particularly important in low-risk populations where the positive predictive value of EIA is relatively low [7–10]. This issue has recently resurfaced in the context of rapid antibody tests, which can provide test results soon after the specimen is obtained at the same visit [11]. These rapid diagnostic tests can be performed in 10–30 minutes, an appealing feature for relatively non-compliant populations and for pregnant women at labor and delivery with an unknown HIV infection status.
- Type
- Chapter
- Information
- Textbook of Pediatric HIV Care , pp. 59 - 67Publisher: Cambridge University PressPrint publication year: 2005