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Title: Early diagnosis of HIV-1-infected infants in Thailand using RNA and DNA PCR assays sensitive to non-B subtypes
Authors: Nancy L. Young
Nathan Shaffer
Thongpoon Chaowanachan
Tawee Chotpitayasunondh
Nirun Vanparapar
Philip A. Mock
Naris Waranawat
Kulkanya Chokephaibulkit
Rutt Chuachoowong
Punneeporn Wasinrapee
Timothy D. Mastro
R. J. Simonds
HIV/AIDS Collaboration
Centers for Disease Control and Prevention
Thailand Ministry of Public Health
Mahidol University
Keywords: Medicine
Issue Date: 15-Aug-2000
Citation: Journal of Acquired Immune Deficiency Syndromes. Vol.24, No.5 (2000), 401-407
Abstract: Objectives: To evaluate the sensitivity and specificity of RNA and DNA polymerase chain reaction (PCR) for early diagnosis of perinatal HIV-1 infection and to investigate early viral dynamics in infected infants Design: A cohort study of 395 non-breastfed infants born to HIV-infected mothers in a randomized clinical trial of short-course antenatal zidovudine. Methods: Infant venous blood specimens collected at birth. 2 months, and 6 months of age were tested by qualitative DNA and quantitative RNA PCR (Roche Amplicor). To determine sensitivity and specificity of DNA and RNA PCR, results were compared with later DNA PCR results and to antibody results at 18 months. The HIV-1 subtype of the mother's infection was determined by peptide serotyping. Results: In the study, 92% of mothers were infected with subtype E. DNA PCR sensitivity was 38% (20 of 53) at birth, and 100.% at 2 months (53 of 53) and 6 months (47 of 47). RNA PCR sensitivity was 47% (25 of 53) at birth and 100% (53 of 53) at 2 months. All samples that tested DNA-positive tested RNA-positive. Specificity was 100% for both DNA and RNA testing at all timepoints. For infected infants, the median viral load of RNA-positive specimens was 407,000 copies/ml (5.6 log10) at birth, 3,700,000 copies/ml (6.6 log10) at 2 months, and 1,700,000 copies/ml (6.2 log10) at 6 months. Infant RNA levels at 2 and 6 months did not differ by maternal zidovudine exposure, or RNA level at birth. Conclusion: This RNA PCR assay performed well for diagnosing perinatal HIV subtype E infection, detecting nearly half of infected infants birth, and 100% at 2 and 6 months, with 100% specificity. Infected infant viral RNA-levels were very high at 2 and 6 months, and were unaffected by maternal zidovudine treatment.
ISSN: 15254135
Appears in Collections:Scopus 1991-2000

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