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Statement by the chairman of the Technical Working Group on Diagnosis of HIV Infection in Women and Children.
In: International Conference on the Implications of AIDS for Mothers and Children: technical statements and selected presentations jointly organized by the Government of France and the World Health Organization, Paris, 27-30 November 1989. Geneva, Switzerland, WHO, Global Programme on AIDS, 1989. 39-40. (WHO/GPA/DIR/89.12)According to World Health Organization estimates, there are about 2 million women and children throughout the world infected with the human immunodeficiency virus (HIV), most of whom remain asymptomatic and unidentified. At least 30% of infants whose mothers are HIV-positive will become infected before, during, or soon after birth. At present, HIV antibody tests are unable to diagnose perinatally acquired HIV infection in infants under 18 months of age. In such cases, the diagnosis can be made only on the basis of clinical signs and symptoms such as unexplained neurological abnormalities, developmental regression, recurrent severe bacterial infections that fail to respond to conventional therapy, lymphocytic interstitial pneumonitis, or opportunistic infections related to cellular immunodeficiency. Given the importance of timely diagnosis of HIV infection, research focused on both the development of sensitive, specific laboratory tests for the diagnosis of HIV in infants under 18 months of age and refinement of the case definition of pediatric acquired immunodeficiency syndrome (AIDS) should be prioritized. Policy decisions as to whether women of reproductive age should be tested for HIV infection should be based on laboratory testing and counseling resources, the availability of medical and social services for women and children, and the overall prevalence of HIV infection in the locality or country.