DIAGNOSIS OF INFECTION WITH HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 BY A DNA-POLYMERASE CHAIN-REACTION ASSAY AMONG INFANTS ENROLLED IN THE WOMEN AND INFANTS TRANSMISSION STUDY

Early diagnosis of infection with human immunodeficiency virus type 1 (HIV-1) in young infants is essential to decisions on their medical an d social care, Whereas studies have suggested that polymerase chain re action (PCR) is a sensitive and timely method of diagnosing HIV infect ion in children, these evaluations have been limited by the number of specimens studied, Recently, Roche Molecular Systems developed a compl ete HIV-1 DNA PCR testing kit (from specimen preparation to detection) , In this study, use of this PCR test kit was evaluated for the detect ion of HIV infection in infants of seropositive mothers who were enrol led in the longitudinal, multicenter Women and Infants' Transmission S tudy. A total of 1209 blood specimens from 483 infants were tested and analyzed, The overall sensitivity and specificity of a single PCR tes t in determining HIV infection status in infants more than 1 but less than 36 months of age were 95% and 97%, respectively. For infected inf ants 1 to 6 months of age the sensitivity of the DNA-PCR test was 90% to 100%, In a direct comparison with coculture, the Roche DNA-PCR test was significantly more sensitive than coculture in the detection of H IV-1 in infected infants and was equivalent to coculture for the diagn osis of HIV in infants when a standardized algorithm was used to defin e infection status.