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Analysis of the influencing factors on serum reversal in HIV-exposed children

Published on Jun. 01, 2024Total Views: 388 timesTotal Downloads: 209 timesDownloadMobile

Author: LI Xiaoling 1 WU Xiaodong 2 YUAN Dongmei 1 HUANG Ting 1 LIU Xiaoning 3 XIA Junxia 4 LI Shaqian 1 HUANG Haiying 1 HE Yun 3

Affiliation: 1. Department of Preventive Health and Nosocomial Infection Management, Shenzhen Third People's Hospital, Shenzhen 518112, Guangdong Province, China 2. Information Section, Shenzhen Third People's Hospital, Shenzhen 518112, Guangdong Province, China 3. Department of Infection and Immunology, Shenzhen Third People's Hospital, Shenzhen 518112, Guangdong Province, China 4. Department of Obstetrics, Shenzhen Third People's Hospital, Shenzhen 518112, Guangdong Province, China

Keywords: HIV-infected pregnant women HIV-exposed children Serum reversal Early infant diagnosis Mother-to-child transmission Nucleic acid test Influencing factors

DOI: 10.12173/j.issn.1004-5511.202311087

Reference: Li X L, Wu XD, Yuan DM, Huang T, Liu XN, Xia JX, Li SQ, Huang HY, He Y. Analysis of the influencing factors on serum reversal in HIV-exposed children[J]. Yixue Xinzhi Zazhi, 2024, 34(5): 516-522. DOI: 10.12173/j.issn.1004-5511.202311087.[Article in Chinese]

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Abstract

Objective  To study the factors influencing serum reversal in HIV-exposed children.

Methods  The general information, clinical data, and serum results of 49 cases of HIV-infected pregnant women and their children exposed to HIV were collected from the Shenzhen Third People's Hospital from January 2019 to December 2021.

Results   All 49 HIV-exposed children were tested negative for HIV nucleic acid at 48 h, 6 weeks, and 3 months of age. The serum reversal rates at 12, 18 and 21 months were 59.18%, 93.87% and 100%, respectively. Whether the serum of HIV-exposed children was reversed at 12 months of age was not related to the maternal delivery, anti-retroviral therapy initiation time, nucleic acid test results, CD4+T lymphocyte count (P>0.05). It was not related to children’s sex, gestational age, birth weight, and the type of blocking drug used (P>0.05).

Conclusion  No clear influencing factors were found for serum reversal in HIV-exposed 12-month-old children. The consistency between nucleic acid detection and final serum reversal was 100%. In order to exclude the possibility of HIV infection as soon as possible and reduce family concerns, three times of negative nucleic acid results before 3 months of age in HIV-exposed children may be considered as a substitute for serum reversal.

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References

1.Bourne DE, Thompson M, Brody LL, et al. Emergence of a peak in early infant mortality due to HIV/AIDS in South Africa[J]. AIDS, 2009, 23(1): 101-106. DOI: 10.1097/qad.0b013e32831c54bd.

2.Chatpornvorarux S, Maleesatharn A, Rungmaitree S, et al. Delayed seroreversion in HIV-exposed uninfected infants[J]. Pediatr Infect Dis J, 2019, 38(1): 65-69. DOI: 10.1097/INF.0000000000002196.

3.Simpson BJ, Andiman WA. Difficulties in assigning human immunodeficiency virus-1 infection and seroreversion status in a cohort of HIV-exposed in children using serologic criteria established by the Centers for Disease Control and Prevention[J]. Pediatrics, 1994, 93(5): 840-842. https://pubmed.ncbi.nlm.nih.gov/8165094/.

4.王述湘, 李向忠, 李琼, 等. HIV感染患者中核酸检测与抗体检测的应用价值[J]. 中国社区医师, 2022, 38(34): 77-79. [Wang SX, Li XJ, Li Q, et al. Application value of nucleic acid detection and antibody detection in HIV infected patients[J]. Chinese Community Doctors, 2022, 38(34): 77-79.] https://www.cnki.com.cn/Article/CJFDTOTAL-XCYS202234027.htm.

5.陈君, 于佳, 邱绣. HIV暴露婴幼儿进行早期诊断的效益与方法[J]. 现代预防医学 2014, 41(22): 4077-4079, 4102. [Chen J, Yu J, Qiu X, et al. Benefits and approaches of early diagnosis for HIV exposed infants and children[J]. Modern Preventive Medicine, 2014, 41(22): 4077-4079, 4102.] https://d.wanfangdata.com.cn/periodical/ChlQZXJpb2RpY2FsQ0hJTmV3UzIwMjMxMjI2Eg94ZHlmeXgyMDE0MjIwMTUaCHJyODI3d2l2.

6.Gutierrez M, Ludwig DA, Khan SS, et al. Has highly active antiretroviral therapy increased the time to seroreversion in HIV exposed but uninfected children?[J]. Clin Infect Dis, 2012, 55(9): 1255-1261. DOI: 10.1093/cid/cis662.

7.Ugochukwu EF, Kanu SO. Early infant diagnosis of HIV infection in southeastern Nigeria: prevalence of HIV infection among HIV-exposed babies[J]. West Afr J Med, 2010, 29(1): 3-7. DOI: 10.4314/wajm.v29i1.55945.

8.Liu A, Zhang L, Zhang X, et al. Delayed seroreversion of specifical antibody against HIV in HIV-exposed infants: a retrospective cohort study[J]. HIV Med, 2020, 21(11): 718-721. DOI: 10.1111/hiv.13026.

9.王娟, 华文浩, 刘方遥, 等. 临床实验室HIV感染的筛查、确认及报告[J]. 临床检验杂志, 2021, 39(11): 805-809. [Wang J, Hua WH, Liu FY, et al. Screening, confirmation and reporting of HIV infection in clinical laboratories[J]. Chinese Journal of Clinical Laboratory Science, 2021, 39(11): 805-809.] DOI: 10.13602/j.cnki.jcls.2021.11.02.

10.张华, 丘小霞. 我国婴儿艾滋病早期诊断工作研究进展[J]. 现代养生, 2019(11): 240-241. [Zhang H, Qiu  XX. Progress in early diagnosis of infant AIDS in China[J]. Health Protection and Promotion, 2019(11): 240-241.] DOI: 10.3969/j.issn.1671-0223(x).2019.11.164.

11.Pitasi MA, Patel SN, Wesolowski LG, et al. Performance of an alternative laboratory-based HIV diagnostic testing algorithm using HIV-1 RNA viral load[J]. Sex Transm Dis, 2020, 47 (5S Suppl 1): 18-25. DOI: 10.1097/OLQ.0000000000001124.

12.中华医学会感染病学分会艾滋病丙型肝炎学组, 中国疾病预防控制中心. 中国艾滋病诊疗指南(2021年版)[J]. 协和医学杂志, 2022, 13(2): 203-226. [Chinese Medical Association Infectious Diseases Branch AIDS Hepatitis C Research Group, Chinese Center for Disease Control and Prevention. China AIDS diagnosis and treatment guidelines (2021 edition)[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(2): 203-226.] DOI: 10.12290/xhyxzz.2022-0097.

13.Qu SL, Wang AL, Pan XP, et al. Estimating the health and economic outcomes of the prevention of mother-to-child transmission of HIV using a decision tree model[J]. Biomed Environ Sci, 2019, 32(1): 68-74. DOI: 10.3967/bes2019.011.

14.Taylor SA, Sharma S, Remmel CAL, et al. HIV-associated alterations of the biophysical features of maternal antibodies correlate with their reduced transfer across the placenta[J]. J Infect Dis, 2022, 226(8): 1441-1450. DOI: 10.1093/infdis/jiac222.

15.Inwani I, Mbori-Ngacha D, Nduati R, et al. Performance of clinical algorithms for HIV-1 diagnosis and antiretroviral initiation among HIV-1-exposed children aged less than 18 months in Kenya[J]. J Acquir Immune Defic Syndr, 2009, 50(5): 492-498. DOI: 10.1097/QAI.0b013e318198a8a4.

16.Su XL, Yao J, Jiang Y, et al. Promising antibody testing strategies for early infant HIV infection diagnosis in China[J]. PLoS One, 2014, 9(6): e99935. DOI: 10.1371/journal.pone.0099935.

17.妇女健康司. 《国家卫生健康委办公厅关于印发预防艾滋病、梅毒和乙肝母婴传播工作规范(2020年版)的通知》(国卫办妇幼函[2020] 928号)[EB/OL]. (2020-11-25)[2023-10-20]. http://www.nhc.gov.cn/fys/s3581/202011/fc7b46b2b48b45a69bd390ae3a62d065.shtml.

18.Chatpornvorarux S, Maleesatharn A, Rungmaitree S, et al. Delayed seroreversion in HIV-exposed uninfected infants[J]. Pediatr Infect Dis J, 2019, 38(1): 65-69. DOI: 10.1097/INF.0000000000002196.

19.强来英, 林旭东, 裴丽健, 等. 人类免疫缺陷病毒感染抗体检测窗口期血清的检出[J]. 中国输血杂志, 2001, 14(6): 340-342. [Qiang LY, Lin XD, Pei LJ, et al. A sample in the HIV-1 antibody window phase deteated by HIV-1RNA and p24 antigen testing[J]. Chinese Journal of Blood Transfusion, 2001, 14(6): 340-342.] DOI: 10.13303/j.cjbt.issn.1004-549x.2001.06.002.

20.李维, 尹丹, 毕蕾静, 等. 献血者HIV RNA窗口期标本的追踪和随访[J]. 中国输血杂志, 2017, 30(6): 611-614. [Li W, Yin D, Bi LJ, et al. Tracking and follow-up study of an HIV RNA window period blood donor[J]. Chinese Journal of Blood Transfusion, 2017, 30(6): 611-614.] DOI: 10.13303/j.cjbt.issn.1004-549x.2017.06.016.

21.潘丽璇, 张园园, 徐晴晴, 等. HIV暴露婴儿出生后不同时段核酸定性检测结果分析[J]. 中国艾滋病性病, 2019, 25(6): 556-558. [Pan LX, Zhang YY, Xu QQ, et al. Analysis of qualitative detection results of nucleic acids in HIV exposed infants at different times after birth[J]. Chinese Journal of AIDS & STD, 2019, 25(6): 556-558.]DOI: 10.13419/j.cnki.aids.2019.06.03.

22.毛旭建, 许健, 周嘉晟, 等. 核酸检测在HIV检测策略中的应用探讨[J]. 中国艾滋病性病, 2023, 29(1): 14-18. [Mao XJ, Xu J, Zhou JS, et al. Application of nucleic acid detection in HIV testing algorithm[J]. Chinese Journal of AIDS & STD, 2023, 29(1): 14-18.] DOI: 10.13419/j.cnki.aids.2023.01.03.

23.孙丽君, 李在村, 王前. 艾滋病病毒感染妊娠妇女治疗及预防艾滋病病毒母婴传播美国指南. 第1版[M]. 北京: 人民卫生出版社, 2019: 234-250. [Sun LJ, Li ZC, Wang  Q. Recommendations for the use of antiretrovisal drugs in pregnant women with HIV infection and interventions to reduce perinatal HIV transmission in the United States[M]. Beijing: People's Medical Publishing House, 2019: 234-250. ]

24.中国疾病预防控制中心, 性病艾滋病预防控制中心. 《全国艾滋病检测技术规范》(2020年修订版)[EB/OL]. (2020-05-18)[2024-03-27], 2019: 234-250. https://ncaids.chinacdc.cn/zxzx/zxdteff/202005/t20200518_216798.htm.

25.李晓玲, 黄婷, 邱谷香, 等. 49例HIV感染孕产妇流行病学特征调查[J]. 传染病信息, 2022, 35(4): 337-341. [Li  XL, Huang T, Qiu GX, et al. Investigation of epidemiological characteristics of 49 HIV-infected pregnant women[J]. Infectious Disease Information, 2022, 35(4): 337-341.] DOI: 10.3969/j.issn.1007-8134.2022. 04.010.

26.沙茵茵, 徐立然, 马秀霞, 等. 成人艾滋病临床指南和共识的质量评价[J]. 中国循证医学杂志, 2022, 22(6): 706-715. [Sha YY, Xu LR, Ma XX, et al. Quality evaluation of clinical quidelines and consensus for adult AIDS[J]. Chinese Journal of Evidence-Based Medicine, 2022, 22(6): 706-715.] https://www.cnki.com.cn/Article/CJFDTotal-ZZXZ202206010.htm.

27.吕艳敏, 韩莉. 育龄妇女预防艾滋病母婴传播知识健康教育干预对提升其自我保护意识的价值[J]. 智慧健康, 2022, 8(3): 139-141, 144. [Lyu YM, Han Li. Value of knowledge health education intervention on preventing mother to child transmission of AIDS to enhances self-protection awareness of women of childbearing age[J]. Smart Healthcare, 2022, 8(3): 139-141, 144.] DOI: 10.19335/j.cnki.2096-1219.2022.3.047.