[Viral load quantification for the early diagnosis of perinatal human immunodeficiency virus 1 (HIV-1) infection].
OBJECTIVE
The aim of this study was to compare the sensitivity and specificity of polymerase chain reaction (DNA-PCR) and virus cultures with HIV-RNA assays (viral load) in the early diagnosis of vertically transmitted HIV-1 infection.


METHODS
One hundred and six infants born to HIV-1 seropositive mothers were divided into three groups: A) Nineteen newborns (24-26 hours of age): B) Twenty-three infants between 1 and 2 months of age; and C) Sixty-four infants older than 2 months. HIV-1 RNA was measured in plasma and HIV proviral DNA was determined in peripheral blood mononuclear cells after amplification by DNA-PCR. The HIV was isolated by a microculture technique.


RESULTS
In the samples obtained during the neonatal period (less than 96 hours of age), 75% of the infants were positive by viral load analysis, 50% by proviral DNA-PCR and only 25% by culture assay. In group B, 100% of the infants were positive by viral load analysis and 85.7% by proviral DNA-PCR and culture assays. Viral load, proviral DNA-PCR and cultures were positive in all infants older than 2 months of age.


CONCLUSIONS
Our results indicate that the 3 techniques, viral load, DNA-PCR and culture, have 100% sensitivity after 2 months of age. However, the viral load technique, which is not routinely used, was found to have a higher sensitivity than proviral DNA-PCR and viral culture in infants younger than 2 months. We conclude that viral load is a useful technique to diagnose HIV infection in newborns.
Departamento de Pediatría, Servicio de Inmunología, Hospital General Universitario Gregorio Marañón, Madrid.
S
S
Resino García
R
R
Alonso Arias
J L
JL
Jiménez Fuentes
D
D
Gurbindo Gutiérrez
M A
MA
Muñoz-Fernández
D004279:DNA, Viral / Q000097:blood*; D015658:HIV Infections / Q000097:blood* / Q000821:virology*; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D018743:Perinatal Care; D016133:Polymerase Chain Reaction / Q000379:methods; D012367:RNA, Viral / Q000097:blood*; D013997:Time Factors
D004279:DNA, Viral; D012367:RNA, Viral