To improve on the early diagnosis of human immunodeficiency virus (HIV) infection, 37 children born to HIV-infected mothers and 22 controls were investigated for in-vitro synthesis of IgG antibody directed against HIV components. For 14 of 16 infected children western blot showed HIV-specific IgG in the supernatants of cultures of their peripheral blood lymphocyte cultures. HIV-specific IgG synthesis was detected in cultures from 4 out of 17 seropositive children aged under 15 months with no clinical or laboratory evidence of infection. No HIV-specific IgG production was observed in cultures from 4 uninfected children or 22 controls. The results show that the demonstration of in-vitro production of HIV-specific IgG may help in the early diagnosis of HIV infection in children.
PIP: Human immunodeficiency virus (HIV) infection in infants born to HIV-positive mothers is difficult to diagnose since the presence of HIV antibody may reflect only maternal IgG, which often persists for up to 15 months. Moreover, existing assays for anti-HIV IgM are of low sensitivity and specificity. The identification of HIV in blood or other tissues indicates infection, but the sensitivity of virus culture is low. To improve on the early diagnosis of HIV infection, 37 children born to HIV-infected mothers and 22 controls were investigated for in-vitro synthesis of IgG antibody directed against HIV components. For 14 of 16 infected children, western blot showed HIV-specific IgG in the supernatants of cultures of their peripheral blood lymphocyte cultures. HIV-specific IgG synthesis was detected in cultures from 4 out of 17 seropositive children aged under 15 months with no clinical or laboratory evidence of infection. No HIV-specific IgG production was observed in cultures from 4 uninfected children or 22 controls. The results reflected de-novo in-vitro synthesis, not transfer of antibody from maternal serum. It is possible, therefore, that testing for in-vitro production of specific IgG antibody could help to distinguish whether HIV-specific antibody in a child's serum had been synthesized by the child's Ig-producing cells or passively transferred from the mother and help in the early diagnosis of HIV infection in children.