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M9651089.TXT
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1996-03-30
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Document 1089
DOCN M9651089
TI Comparison of a rapid nonisotopic polymerase chain reaction assay with
four commonly used methods for the early diagnosis of human
immunodeficiency virus type 1 infection in neonates and children.
DT 9505
AU Kovacs A; Xu J; Rasheed S; Li XL; Kogan T; Lee M; Liu C; Chan L;
Comprehensive Maternal-Child HIV Management and Research Center,; Los
Angeles County and University of Southern California Medical; Center
90033, USA.
SO Pediatr Infect Dis J. 1995 Nov;14(11):948-54. Unique Identifier :
AIDSLINE MED/96147526
AB To initiate antiretroviral therapy and prophylaxis for Pneumocystis
carinii pneumonia, it is important to identify human immunodeficiency
virus (HIV-1)-infected infants as soon after birth as possible. This
study was undertaken to evaluate a novel 5-hour nonisotopic (NI)
polymerase chain reaction (PCR) assay (Amplicor PCR; Roche Molecular
Systems) and four other commonly used HIV-1 diagnostic tests including
culture, oligonucleotide hybridization PCR, p24 antigen and immune
complex-dissociated (ICD) p24 antigen tests and to determine the optimal
age at which to perform these tests for the early and rapid diagnosis of
HIV-1 in infants and children. We prospectively evaluated 225 infants
and children, including 114 neonates, for HIV-1 infection. HIV-1
infection was defined as 2 positive HIV cultures. Of the 225 infants and
children, 57 were infected, 138 were uninfected and 30 were of unknown
(Centers for Disease Control and Prevention Classification P0) status.
The sensitivity of NI PCR was 60% in cord blood, 40% at 0 to 2 days, 67
to 80% in the neonate (3 to 30 days) and 95 to 100% after 1 month of
age. NI PCR was as sensitive as oligonucleotide hybridization PCR,
culture, p24 antigen and ICD p24 antigen in the first 2 months of life
and was more sensitive than p24 antigen or ICD p24 antigen thereafter.
Specificity was 94% for cord blood and 99 to 100% for all age groups.
The majority of HIV-1-infected newborns can be identified with NI PCR if
testing is performed at birth and again between the third and fourth
weeks of life. For older infants and children 2 NI PCR tests can
correctly diagnose 98.5% of infected and uninfected infants and
children. NI PCR of umbilical cord blood might also be useful as an
initial screening test to identify infants who may be infected with
HIV-1.
DE AIDS Serodiagnosis/*METHODS Child, Preschool Comparative Study Female
Fetal Blood/VIROLOGY Human HIV Core Protein p24/ANALYSIS HIV
Infections/*CONGENITAL/*DIAGNOSIS HIV-1/*ISOLATION & PURIF Infant
Infant, Newborn Male Polymerase Chain Reaction/*METHODS Sensitivity
and Specificity Support, Non-U.S. Gov't Support, U.S. Gov't, P.H.S.
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).