Pamela got me thinking about my comment in regard to the use of PCR for testing infants under one month. My notes had the comment that 50% were false positives and the reason for not using PCR in the first month. What my reference says is that the "sensitivity of this assay is sufficient to detect about half of infections in the first month of life." My other reference states that "false positive results due to contamination are the major pitfall of this test." I think I must have put the two ideas together and written it in my notes. One of the references goes on to say: "PCR is not recommended as a diagnostic test for postexposure diagnosis of HIV infection either following needlestick or sexual exposure because of misleading false positive or false negative results....It must be emphasized that virological diagnosis still largely depends on clinical and epidemiological criteria, with laboratory tests including PCR functioning in a complementary supportive role." from the National Institute of Virology, University of Witwatersrand, South Africa http://www.niv.ac.za/lessons/current/les10_1.htm The PCR test kits use to and still may say that the test should not be used as a diagnostic. In a book called Mother to Child Transmission of Hiv and its Prevention with AZT and Nevirapine: A Critical Analysis of the Evidence by Eleopulos et al. there is quote from researchers in the USA who did a meta-analysis of studies published between 1988-1994 on PCR sensitivity and specificity. The researchers from this meta-analysis state, "The false-positive and false-negative rates of PCR that we determined are too high to warrant a broader role for PCR in either routine screening or in the confirmation of diagnosis of HIV infection." I find it very difficult in the light of how unreliable this testing is and the confusion of maternal antibodies in the infant's bloodstream to believe that we have the evidence to believe that breastfeeding is one of the routes of hiv transmission. The case that was brought up on this list as the first documented case of hiv transmission through breastfeeding must be the case of Elizabeth and Ariel Glasser. I believe there is grounds to believe that it was blood transfusions, not breastfeeding, that caused that hiv transmission. Valerie W. McClain, IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html