title: Early HIV-1 diagnosis using in-house real-time PCR amplification on dried blood spots for infants in remote and resource-limited settings.
abstract: BACKGROUND
  In resource-limited settings, most perinatally HIV-1-infected infants do not receive timely antiretroviral therapy because early HIV-1 diagnosis is not available or affordable.
  
  
  OBJECTIVE
  To assess the performance of a low-cost in-house real-time polymerase chain reaction (PCR) assay to detect HIV-1 DNA in infant dried blood spots (DBS).
  
  
  METHODS
  One thousand three hundred nineteen DBS collected throughout Thailand from non-breast-fed infants born to HIV-1-infected mothers were shipped at room temperature to a central laboratory.In-house real-time DNA PCR results were compared with Roche Amplicor HIV-1 DNA test (Version 1.5) results. In addition, we verified the Roche test performance on DBS sampled from 1218 other infants using as reference HIV serology result at 18 months of age.
  
  
  RESULTS
  Real-time DNA PCR and Roche DNA PCR results were 100% concordant. Compared with HIV serology results, the Roche test sensitivity was 98.6% (95% confidence interval: 92.6% to 100.0%) and its specificity at 4 months of age was 99.7% (95% confidence interval: 99.2% to 99.9%).
  
  
  CONCLUSIONS
  In-house real-time PCR performed as well as the Roche test in detecting HIV-1 DNA on DBS in Thailand. Combined use of DBS and real-time PCR assays is a reliable and affordable tool to expand access to early HIV-1 diagnosis in remote and resource-limited settings, enabling timely treatment for HIV-1-infected infants.
authors.affiliation: Département Sociétés et Santé, Institut de Recherche pour le Développement, U174-Program for HIV Prevention and Treatment, Chiang Mai, Thailand. nicole@phpt.org
authors.forename: Nicole
authors.initials: N
authors.lastname: Ngo-Giang-Huong
authors.forename: Woottichai
authors.initials: W
authors.lastname: Khamduang
authors.forename: Baptiste
authors.initials: B
authors.lastname: Leurent
authors.forename: Intira
authors.initials: I
authors.lastname: Collins
authors.forename: Issaren
authors.initials: I
authors.lastname: Nantasen
authors.forename: Pranee
authors.initials: P
authors.lastname: Leechanachai
authors.forename: Wasna
authors.initials: W
authors.lastname: Sirirungsi
authors.forename: Aram
authors.initials: A
authors.lastname: Limtrakul
authors.forename: Tasana
authors.initials: T
authors.lastname: Leusaree
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Comeau
authors.forename: Marc
authors.initials: M
authors.lastname: Lallemant
authors.forename: Gonzague
authors.initials: G
authors.lastname: Jourdain
mesh_terms: D004279:DNA, Viral / Q000097:blood; D003695:Delivery of Health Care / Q000191:economics; D003906:Developing Countries; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000191:economics; D015497:HIV-1 / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000191:economics; D018445:Infectious Disease Transmission, Vertical; D016133:Polymerase Chain Reaction / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013785:Thailand
chemical_list: D004279:DNA, Viral