LABORATORY DIAGNOSIS OF INFECTION STATUS IN INFANTS PERINATALLY EXPOSED TO HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1

Accurate and timely diagnosis of infection status in infants born to w omen infected with human immunodeficiency virus (HIV) is of paramount importance. The comparative accuracy of five diagnostic decision rules was evaluated in 208 HIV-exposed infants (32 infected, 176 uninfected ) based on laboratory testing during the first 6 months of life, Diagn ostic rules A and B, which required single blood samples analyzed by c ulture and polymerase chain reaction (PCR) (rule A) or culture, PCR, a nd p24 antigen detection (rule B) were more prone to incorrect diagnos es than were rules requiring 2 blood samples analyzed by a single assa y (rule C) or combinations of culture and PCR (rules D and E), Rule D, which used PCR as the initial test, established the most useful algor ithm: a positive PCR result followed by a positive culture in the seco nd sample confirmed infected status, while two consecutive negative PC R results reconfirmed as negative at 6 months of age established uninf ected status.