The standard screening test for HIV infection is called the ELISA. This test checks for the HIV antibody. A positive result does not necessarily mean that the patient is ill. It needs to be confirmed with a more specific test called a western blot test. This test is extremely important because some persons can have a non-viral (other medical or immunologic conditions) that can give a false positive ELISA test result.

Rarely, (in less than 1%) will an infected person fail to make antibody response to the HIV virus but these patients are usually obviously very ill. A similar situation may occur[gr1] in the very early weeks after the maternal primary infection with the HIV virus. Almost always in both these types situations the more sophisticated test like (western blot, viral cultures, PCR) is always positive. Infants who are born to HIV-infected mothers will have positive test results for the HIV antibody, regardless of infection status. This is due to the maternal transplacental passage of maternal antibodies to the infant.

The average time to lose the maternal HIV antibody is about 10 months of age while all children lose the maternal HIV antibody by 18 months of age. A diagnosis for HIV can usually be made by 2 – 4 months of age if the test performed are checking for HIV virus in the blood (nucleic acid detection or HIV culture). In an infant who was exposed to HIV mother, a negative test result during the early period of life does not reliably rule out infection, but if this infant is otherwise well, and has had at least two negative HIV cultures or nucleic acid test performed over the age of one month and another over the age of 3 months, this infant is unlikely to be infected. These infants should be monitored for signs and symptoms of the disease and should also be retested at 12 mo, 15 mo , 18mo and 24 mo. In order to look for a reversion to a negative status and to confirm the absence of the infection. For the above referenced child we need to ask a few questions:

If the appropriate test was indeed performed and this child did not present with an unusual amount of infections, chances are good that this child has not contracted the HIV disease. Obviously, as per the follow-up protocol, we need to perform more HIV testing at 18 months of age and 24 months of age. If the titers continue to remain negative, the patient is a more than likely clear.

The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it -- only after a careful history and physical exam can a medical diagnosis and treatment plan be made.