Quantitative RNA testing for diagnosis of HIV-infected infants.
Quantitative HIV RNA testing was used for diagnosis in 156 HIV-exposed non-breast-fed infants at less than 6 months of age (54 infected, 102 uninfected) enrolled in the Perinatal AIDS Collaborative Transmission Study. Sensitivity was 29% in the first week, 79% at 8 to 28 days of age, and >90% at 29 days of age and thereafter; specificity was 100% in all periods, except at 29 to 60 days of age, when specificity was 93%. Neither sensitivity nor specificity was significantly affected by maternal or infant zidovudine (ZDV) treatment, even though infant viral loads were lower during the first 6 weeks in infants who received perinatal ZDV prophylaxis ( p=.005). Paired analysis of DNA and RNA measurements revealed no advantage for either test. Quantitative RNA testing can be used for diagnosis in HIV-exposed infants, recognizing the chance for a false-positive test result. It may be most useful as a confirmatory test in infants with another positive diagnostic test result.
Nesheim
Steven
S
Emory University School of Medicine, Department of Pediatrics, Infectious Diseases, Epidemiology and Immunology, 69 Butler Street SE, Atlanta, GA 30335, USA. steve_nesheim@oz.ped.emory.edu
Palumbo
Paul
P
Sullivan
Kevin
K
Lee
Francis
F
Vink
Peter
P
Abrams
Elaine
E
Bulterys
Marc
M
D019380:Anti-HIV Agents / Q000627:therapeutic use; D001903:Bottle Feeding; D004279:DNA, Viral / Q000032:analysis; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011533:Proviruses / Q000235:genetics / Q000302:isolation & purification; D012367:RNA, Viral / Q000032:analysis; D019562:Viral Load / Q000379:methods; D015215:Zidovudine / Q000627:therapeutic use
D019380:Anti-HIV Agents; D004279:DNA, Viral; D012367:RNA, Viral; D015215:Zidovudine