Chantry C J, Cooper E R, Pelton S I, Zorilla C, Hillyer G V, Diaz C
Department of Pediatrics, University of Puerto Rico School of Medicine, San Juan.
Pediatr Infect Dis J. 1995 May;14(5):382-7. doi: 10.1097/00006454-199505000-00009.
The goal of this study was to describe seroreversion (SR) in a cohort of human immunodeficiency virus-exposed but uninfected infants. Groups of patients who seroreverted very early or late were examined for salient clinical and immunologic characteristics of the mother or infant. The mean time (+/- s.d.) to seroreversion by enzyme-linked immunoabsorbent assay (ELISA) was 50.1 +/- 14.8 weeks, or 11.6 months (n = 84); the range of times to antibody loss by ELISA was 17.9 to 82.0 weeks. The mean time to seroreversion by Western blot was 68.3 +/- 12.6 weeks, or 15.8 months (n = 51), with a range of 44.9 to 94.1 weeks. Initial anti-human immunodeficiency virus titer as measured by cord blood ELISA optical density (OD) was found to relate significantly to mean time to seroreversion. No relationship to time to seroreversion was demonstrated for gestational age, maternal or neonatal serum immunoglobulin concentrations, maternal CD4 cell counts, maternal alcohol consumption, infantile diarrhea or failure to thrive. The lengthy time to seroreversion seen here demonstrates the 1994 revised Centers for Disease Control and Prevention definition of human immunodeficiency virus infection (based on seropositivity by both ELISA and confirmatory tests persisting beyond 18 months of age) to be accurate in our population. We recommend Western blot testing be used as confirmation for positive ELISAs only after 18 months of age.
本研究的目的是描述一组暴露于人类免疫缺陷病毒但未感染的婴儿中的血清学逆转（SR）情况。对血清学逆转非常早或非常晚的患者组进行了母亲或婴儿显著临床和免疫学特征的检查。通过酶联免疫吸附测定（ELISA）进行血清学逆转的平均时间（±标准差）为50.1±14.8周，即11.6个月（n = 84）；通过ELISA检测抗体消失的时间范围为17.9至82.0周。通过蛋白质印迹法进行血清学逆转的平均时间为68.3±12.6周，即15.8个月（n = 51），范围为44.9至94.1周。发现通过脐血ELISA光密度（OD）测量的初始抗人类免疫缺陷病毒滴度与血清学逆转的平均时间显著相关。未发现胎龄、母亲或新生儿血清免疫球蛋白浓度、母亲CD4细胞计数、母亲饮酒、婴儿腹泻或发育不良与血清学逆转时间之间存在关联。此处观察到的血清学逆转时间较长表明，1994年美国疾病控制与预防中心修订的人类免疫缺陷病毒感染定义（基于ELISA和确证试验均呈血清阳性且持续超过18个月龄）在我们的人群中是准确的。我们建议仅在18个月龄后才使用蛋白质印迹试验作为ELISA阳性结果的确证。
