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Discordant HIV DNA PCR results among infants diagnosed with HIV infection and initiated on ART: a case series
Dhanashree D Jagtap1, Nilesh C Gawde2, Suchit V Kamble1
11 National AIDS Research Institute (ICMR), Pune India.
Insights
Three infants diagnosed with HIV-1 via DNA PCR testing showed negative serology after antiretroviral therapy (ART). This seroreversion warrants further investigation into viral suppression or PCR accuracy in pediatric HIV cases.
Area of Science:
- Pediatric Infectious Diseases
- Virology
- Clinical Immunology
Background:
- Early diagnosis of Human Immunodeficiency Virus type 1 (HIV-1) infection in infants is crucial for timely intervention.
- DNA polymerase chain reaction (PCR) is a key diagnostic tool for detecting HIV-1 in infants.
Observation:
- A case series involving three infants diagnosed with HIV-1 infection using DNA PCR.
- All infants initiated antiretroviral therapy (ART) between 4 and 10 months of age.
- Follow-up serological testing at 18 months indicated HIV-1 negativity in all three infants.
Findings:
- Two infants remained serologically negative for HIV-1 despite initial positive DNA PCR results and subsequent ART.
- One infant was discontinued from ART, while the other two continued therapy.
- Observed seroreversion suggests potential viral suppression or false-positive DNA PCR results.
Implications:
- Discordant results between DNA PCR and serology in infants require careful management and further evaluation.
- Need for updated clinical guidelines to address seroreversion in pediatric HIV cases.
- Investigating the causes of discordant results is essential for accurate diagnosis and treatment monitoring.
Abstract:
This case series reports three infants diagnosed with HIV-1 infection using DNA polymerase chain reaction (PCR) testing. The three children were initiated on antiretroviral therapy (ART) at ten, four and six months of age. Their serological tests at 18 months of age were negative for HIV-1. The first child was discontinued from ART. The other two children were HIV-negative after 18 months, but were continued on ART. Such seroreversion may be either due to viral suppression or false-positive DNA PCR results. There is a need to develop guidelines to address such discordant cases.
