[Early diagnosis of HIV infection in children born to seropositive mothers]. / Diagnóstico temprano de infección por VIH en niños nacidos de madres seropositivas.

We have studied 70 children, born to HIV seropositive mothers, since the first trimester of life and every three months thereafter. The virological markers we used in the diagnosis included: 1) p24 antigen detection. 2) Autochthonous production of antibodies detected by Western Blot technique. 3) HIV isolation. 4) Specific determination of IgM antibodies. In infected children under 15 months of age, p24 antigen was positive in 78%, HIV was isolated in 75% and autochthonous production of antibodies occurred in 50%. IgM specific antibodies were detected in 92%, but these were also detected in the 33% of the children who seroreverted. In seroreverted children, the other three virological markers were negative. The problems due to the low sensitivity in p24 antigen detection, HIV isolation and the detection of autochthonous production of antibodies, as well as the low specificity of the IgM detection, means that it is necessary to simultaneously use several techniques in the diagnosis of these children.

[HIV infection in infants under 15 months of age. Value of the p-24 antigen as a prognostic marker]. / Infección por el virus de la inmunodeficiencia humana en niños menores de 15 meses. Valoración del antígeno p-24 como marcador pronóstico.

We have studied 65 children, born to HIV seropositive mothers, during the first quarter of life and afterwards every three-months. During this time, ten of the children (13%) became infected with the virus. The study of p24 antigen during the first 15 months of life showed an inverse relationship between the permanent presence of P24 antigen in the serum and the absence of anti-p24 antibodies. Since both markers were related to a bad prognosis, it is useful to carry-out the routine study of p24 antigen and its level in serum. Of the infections detected, 3 cases were early onset and the other 7 cases later onset. The three children from the first group died between 4 and 8 months of life, while the second group had a much more stable clinical situation. The children with early onset infections had T4 lymphocytes lower than 500 cell/mm3, detectable p24 antigen, and a fatal progression of the disease.