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1994-10-25
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Document 2652
DOCN M94A2652
TI Neonatal diagnosis of perinatal HIV-1 infection: the use of polymerase
chain reaction in Brazilian infants.
DT 9412
AU Mussi-Pinhata MM; Feres MC; Covas DT; Duarte G; Isaac ML; Clinical
Hospital of Medical School of Ribeirao Preto-Un. of Sao; Paulo, Brazil.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):255 (abstract no. PB0449). Unique
Identifier : AIDSLINE ICA10/94369923
AB OBJECTIVE: To evaluate the ability of the HIV-1
polymerase-chain-reaction (PCR) testing to diagnose HIV-1 infection in
neonates born to HIV-1 infected women in Ribeirao Preto. METHODS: Thirty
seven infants born to HIV-1 infected women followed prospectively from
birth had a neonatal blood sample (median age of 5.5 days, range 1 to 28
days) tested by standard HIV-1 PCR (1 gag primer pair SK 38/39 and 1 env
primer pair SK 68/69). The infants HIV-1 infection status was determined
based on clinical signs and symptoms of disease (CDC criteria) and/or
serology after 18 months of age. The neonatal PCR testing results were
compared to the infection status of the infants. RESULTS: Of 30 children
with complete follow up (median of 21 months), 9 (30%) had serological
and clinical signs of HIV-1 infection and 21 (70%) were not infected.
All the 9 infected infants were asymptomatic in the neonatal period.
Among the infected infants. 5/9 (56%) had positive neonatal PCR tests
and 4/9 (44%) had negative PCR tests. None of the 21 not infected
children had positive PCR tests (specificity of 100%). The predictive
value of a positive test was 100% and the predictive value of a negative
test was 84%. Infected infants developed early (1 to 6 months of age)
signs and symptoms of disease despite of their reactivity on neonatal
PCR testing. The prognosis of PCR-positive and PCR-negative infants were
similar. DISCUSSION AND CONCLUSIONS: The PCR testing done in the
neonatal period detected half of the perinataly infected infants with
good specificity. In spite of not detecting all infants, it is a useful
tool for neonatal diagnosis and it might be identifying the newborns
infected during gestation. This test should be repeated after the
neonatal period to enhance its sensitivity. In addition, cheaper and
less complex tests must be evaluated in developing countries for early
diagnosis of perinatal HIV-1 infection.
DE Brazil *Developing Countries Female Follow-Up Studies Human HIV
Seropositivity/*DIAGNOSIS/TRANSMISSION *HIV-1 Infant Infant, Newborn
Male Neonatal Screening Polymerase Chain Reaction/*METHODS Pregnancy
Prospective Studies MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).