RELIABILITY OF LABORATORY MARKERS OF HIV-1 INFECTION IN ARGENTINEAN INFANTS AT RISK OF PERINATAL INFECTION

Citation
A. Mangano et al., RELIABILITY OF LABORATORY MARKERS OF HIV-1 INFECTION IN ARGENTINEAN INFANTS AT RISK OF PERINATAL INFECTION, AIDS patient care and STDs, 12(9), 1998, pp. 691-696
Citations number
18
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Public, Environmental & Occupation Heath",Nursing
Journal title
ISSN journal
1087-2914
Volume
12
Issue
9
Year of publication
1998
Pages
691 - 696
Database
ISI
SICI code
1087-2914(1998)12:9<691:ROLMOH>2.0.ZU;2-D
Abstract
Early and accurate diagnosis of HIV-1 infection in infants born to HIV -1-seropositive mothers is of great importance. Polymerase chain react ion (PCR), HIV culture, and p24 antigen detection assays were evaluate d for their ability to detect the presence of HIV in 195 infants at ri sk of perinatal infection. Using the Centers for Disease Control and P revention guidelines for assessing HIV infection status in children yo unger than 18 months, 70 infants (36%) were diagnosed as HIV-1 infecte d and 125 (64%) lacked virologic and clinical evidence of infection. P CR and HIV culture were the most sensitive laboratory markers, detecti ng 100% and 98% of positive samples, respectively, regardless of age a t testing. HIV-1 p24 antigen assay was detected in 26 of 38 positive s amples but not in negative samples. PCR was performed with three diffe rent sets of primers (SK38/SK39-SK19-gag, SK68/SK69-SK70-env, and SK15 0/SK431-SK102-gag). The sensitivity/specificity of the individual assa ys were for SK19, 96.1%/94.25%; SK70, 89.6%/100%; and SK102, 100%/100% . A sample was considered HIV-1 positive when two positive PCR results were obtained with two different pairs of primers, and negative if th e sample was negative when three sets of primers were used. False-posi tive results were occasionally obtained with probe SK19 in six serorev erter infants before serologic status was known. This suggested that t he infection was caused by nonreplicative strains or were false-positi ve results probably by nonspecific amplification due to cross-reaction with other microorganisms; contamination was discarded because there was no specific amplification with the other two primers. All the HIV- 1-infected infants were correctly identified with PCR; all except one could be identified with coculture and only 68.4% were confirmed with p24 antigen assay. No seroreverter infant was misdiagnosed using the c riteria selected.