RT Journal Article
SR Electronic
T1 HIV-1 seronegativity in a child with proved perinatal HIV infection on HAART
JF Sexually Transmitted Infections
JO Sex Transm Infect
FD BMJ Publishing Group Ltd
SP 377
OP 379
DO 10.1136/sti.2004.011973
VO 81
IS 5
A1 N Desai
A1 M Mathur
A1 K Abu-Lawi
YR 2005
UL http://sti.bmj.com/content/81/5/377.abstract
AB Objectives: To report the unexpected absence of HIV-1 antibodies and provirus in the peripheral blood of a 4 year old with previously diagnosed perinatal HIV infection. Methods: Case study including review of clinic and laboratory records and confirmation of results of HIV-1 enzyme linked immunosorbent assay (ELISA), western blot, and HIV-1 DNA PCR from reference laboratory. Results: This child had high plasma viral load at the initiation of highly active antiretroviral therapy (HAART) at 10 months of age. Following undetectable HIV viraemia continuously for a 3 year period, he had normal CD4 and immunoglobulin levels. When retested at the request of the parent, HIV-1 ELISA, western blot, and HIV DNA PCR were all negative, raising the question of misdiagnosis and the parental misperception of a “cure.” A rebound increase in viral load on cessation of therapy led to these diagnostic tests becoming positive again, with better parental acceptance of the diagnosis and treatment plan. Conclusions: Patients and providers should exercise caution in interpreting negative serological tests in children on HAART.