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Diagnosis of perinatal HIV-1 infection by in-house PCR
S Vongsheree1, N Ruchusatsawat, S Saguanwongse
1Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand.
Insights
This study evaluated an in-house Polymerase Chain Reaction (PCR) diagnostic test for infants born to mothers with Human Immunodeficiency Virus type 1 (HIV-1). The PCR test demonstrated high sensitivity and specificity, enabling early identification of HIV-1 infection in infants.
Area of Science:
- Medical Diagnostics
- Virology
- Pediatric Infectious Diseases
Background:
- Vertical transmission of Human Immunodeficiency Virus type 1 (HIV-1) remains a significant global health concern.
- Early and accurate diagnosis of HIV-1 infection in infants is crucial for timely intervention and improved outcomes.
- Existing diagnostic methods may have limitations in terms of speed and sensitivity for early detection.
Purpose of the Study:
- To evaluate the performance of an in-house Polymerase Chain Reaction (PCR) assay for diagnosing HIV-1 infection in infants born to HIV-1 infected mothers.
- To compare the diagnostic capabilities of the in-house PCR assay with clinical and serological assessments.
- To determine the feasibility and cost-effectiveness of implementing this PCR assay in resource-limited settings.
Main Methods:
- An open cohort study involving 130 infants born to HIV-1 infected mothers was conducted.
- Infants were monitored from birth up to 18 months of age, with regular clinical evaluations and blood sampling.
- Specimen processing and an in-house PCR analysis were performed using available facilities and personnel to detect HIV-1 DNA.
Main Results:
- The in-house PCR assay achieved 100% sensitivity and 94.4% specificity within 6 months of birth, compared to established infection status.
- Clinical diagnosis alone could only identify infected infants at 9 months of age.
- The overall mother-to-infant HIV-1 transmission rate in this cohort was 23.2%.
Conclusions:
- The developed in-house PCR assay provides a sensitive and specific tool for the early diagnosis of vertical HIV-1 transmission.
- Despite not having optimal specificity, the PCR test is beneficial for identifying uninfected infants early, potentially avoiding unnecessary medical care.
- This low-cost, in-house PCR assay offers a viable option for improving HIV-1 diagnosis in infants, particularly in settings with limited resources.
Abstract:
A study on how to apply PCR as a diagnostic test for the infants born to HIV-1 infected mothers is described. All steps including clinical care, blood sampling, specimen processing and PCR analysis were carried out using native facilities and personnel. An open cohort of 130 children was evaluated at birth, 1, 6, 9, 15, and 18 months of age. Definite infection status was assessed by clinical and serological data during an 18 months of follow up period. PCR results were reported as positive or negative when at least 2 concordant data were denoted. This in-house PCR, compared to known infection status, gave 100% sensitivity and 94.4% specificity within 6 months after birth. On the other hand, clinical diagnosis could identify only the infected infants at 9 months of age. The HIV-1 transmission rate from mother to infant was 23.2%. Though this PCR was not at an optimal level of specificity, it was still beneficial to identify uninfected infants in the first year of their lives and avoid unnecessary medical care. Here, we report an in-house PCR that offers good performance at low cost for the diagnosis of HIV-1 vertical transmission.