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Repeatedly positive human immunodeficiency virus type 1 DNA polymerase chain reaction in human immunodeficiency
S S Bakshi1, S Tetali, E J Abrams
1Department of Pediatrics, North Shore University Hospital, Cornell University Medical College, Manhasset, NY, USA.
Insights
Three HIV-exposed infants with repeated positive DNA PCR tests achieved HIV-negative status. This transient positivity may suggest immune system clearance or a defective virus strain.
Area of Science:
- Virology
- Immunology
- Pediatrics
Background:
- Mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) remains a significant concern.
- Early diagnosis in infants is crucial for timely intervention and management.
- Seroreversion, the loss of detectable antibodies, can occur in some HIV-exposed infants.
Purpose of the Study:
- To report on a unique subset of HIV-exposed infants who exhibited transiently positive DNA polymerase chain reaction (PCR) results.
- To investigate the potential implications of these findings for understanding HIV infection dynamics in infants.
Main Methods:
- Analysis of a cohort of 210 infants born to HIV-infected mothers.
- Serial testing using HIV viral culture, DNA PCR, and p24 antigen assays at 1-3 month intervals.
- Detailed clinical assessment and CD4:CD8 ratio monitoring in the reported cases.
Main Results:
- Three infants had persistently positive DNA PCR tests (≥5 samples) before achieving HIV-negative status (seroreversion).
- Other diagnostic methods (viral culture, p24 antigen) remained negative in these cases.
- Clinical features were similar to other seroreverters, with a transient drop in CD4:CD8 ratio (<1.0).
Conclusions:
- Transiently positive DNA PCR in HIV-exposed infants may indicate successful viral clearance by a robust host immune response.
- Alternatively, it could suggest infection with an attenuated or defective strain of HIV-1.
- Further research is needed to elucidate the mechanisms behind transient HIV-1 positivity and seroreversion.
Abstract:
Three human immunodeficiency virus type 1 (HIV-1)-exposed children who had repeatedly positive DNA polymerase chain reaction (PCR) tests for HIV in > or = 5 samples before seroreversion to HIV-negative status are reported. The children belong to a cohort of 210 infants who were born to HIV-infected mothers and were tested at intervals of 1 to 3 months by HIV viral culture, PCR, and p24 antigen; only the PCR was positive in > or = 5 samples in the children reported here. Their clinical features were indistinguishable from other seroreverters. All three children had a transient drop in CD4:CD8 ratio to < 1.0. The transiently positive DNA PCR in HIV-exposed infants may indicate either that HIV infection was eliminated by a strong host immune response or that infection was caused by an attenuated/defective strain of virus.