This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'All of the following methods are used for the diagnosis of HIV infection in a 2 month old child, except – \nSelect and explain. \nA. DNA–PCR, B. Viral culture, C. HIV ELISA, D. p24 antigen assay', 'role': 'user'}, {'content': "Answer: C \nExplanation: Diagnosis of HIV in Infant\n\nIn adults HIV can be easily diagnosed by detecting IgG antibody to HIV (Elisa and western blot test). But this method is not helpful in case of neonates because all neonates born to HIV infected mothers will have IgG antibody in their blood, regardless of infection status in them. These antibodies are passively transferred to the newborns from their mothers (IgG can cross placenta). These infants continue to test positive for IgG antibodies for upto 18 months. At the end of 18 month they will lose these antibodies so uptil 18 month of age this method of diagnosis cannot be used.\nThe presence of IgA or IgM anti HIV in the infant's blood can indicate HIV infection, because these classes of antibodies do not cross the placenta. However detectable quantities of IgA antibodies are detected only after 3 months of life and detection of IgM antibodies is very unreliable (both insensitive and nonspecific).\nSo direct viral detection assays are used for the diagnoses of HIV in newborn. These are\n\n\ndetection of HIV DNA or RNA by PCR. \xa0 \xa0 \xa0 \xa0 \xa0\nHIV culture\nHIV p24 antigen\nImmune complex dissociated p24 antigen\xa0 \xa0 \xa0 \xa0\xa0\n\nThese are very useful in young infants allowing a definitive diagnosis in most infected infants by 1— 6 months of age. Out of these method detection of viral DNA by PCR is the preferred method in developed countries.", 'role': 'assistant'}]