title: Performance of HIV-1 DNA or HIV-1 RNA tests for early diagnosis of perinatal HIV-1 infection during anti-retroviral prophylaxis.
abstract: OBJECTIVE
  To compare performance of testing for human immunodeficiency virus (HIV)-1 DNA and HIV-1 RNA for diagnosis of HIV-1 infection in infants receiving preventive antiretroviral therapy.
  
  
  METHODS
  This substudy of the French multicenter prospective cohort of neonates born to HIV-infected mothers, included 1567 infants tested for HIV with polymerase chain reaction (PCR) in a single laboratory, receiving post-natal prophylaxis, not breastfed, and having simultaneous HIV-1 DNA and RNA results before 45 days. The performance of PCR was assessed in reference to the 6-month HIV-1 RNA result.
  
  
  RESULTS
  Specificity of both HIV-1 RNA and HIV-1 DNA PCR was 100% at all ages (except 99.8% for DNA at birth); sensitivity was 58% (RNA) and 55% (DNA) at birth, and 89% at 1 month, 100% at 3 months for both, and 100% at 6 months (DNA). Concordance between HIV-1 DNA and RNA results was 0.78 and 0.81 (Kappa) at birth and 1 month and 100% at 3 and 6 months. Type of maternal and neonatal prophylaxis had no effect on sensitivity, but influenced viral load.
  
  
  CONCLUSIONS
  The performances of testing for HIV-1 DNA and RNA were similar with 100% sensitivity at 3 months. At 1 month during prophylaxis, 11% of infected children had negative PCR results.
authors.affiliation: Laboratoire de Virologie, Hôpital Necker, AP-HP, Paris, France. marianne.burgard@nck.aphp.fr
authors.forename: Marianne
authors.initials: M
authors.lastname: Burgard
authors.forename: Stéphane
authors.initials: S
authors.lastname: Blanche
authors.forename: Carine
authors.initials: C
authors.lastname: Jasseron
authors.forename: Philippe
authors.initials: P
authors.lastname: Descamps
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Allemon
authors.forename: Nicole
authors.initials: N
authors.lastname: Ciraru-Vigneron
authors.forename: Corinne
authors.initials: C
authors.lastname: Floch
authors.forename: Brigitte
authors.initials: B
authors.lastname: Heller-Roussin
authors.forename: Eric
authors.initials: E
authors.lastname: Lachassinne
authors.forename: Fabienne
authors.initials: F
authors.lastname: Mazy
authors.forename: Josiane
authors.initials: J
authors.lastname: Warszawski
authors.forename: Christine
authors.initials: C
authors.lastname: Rouzioux
mesh_terms: D004279:DNA, Viral / Q000032:analysis; D042241:Early Diagnosis; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D012680:Sensitivity and Specificity
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral