Quantitative RNA testing for diagnosis of HIV-infected infants |
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Authors: | Nesheim Steven Palumbo Paul Sullivan Kevin Lee Francis Vink Peter Abrams Elaine Bulterys Marc |
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Institution: | Emory University School of Medicine, Department of Pediatrics, Infectious Diseases, Epidemiology and Immunology, 69 Butler Street SE, Atlanta, GA 30335, USA. steve_nesheim@oz.ped.emory.edu |
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Abstract: | Quantitative HIV RNA testing was used for diagnosis in 156 HIV-exposed non-breast-fed infants at less than 6 months of age (54 infected, 102 uninfected) enrolled in the Perinatal AIDS Collaborative Transmission Study. Sensitivity was 29% in the first week, 79% at 8 to 28 days of age, and >90% at 29 days of age and thereafter; specificity was 100% in all periods, except at 29 to 60 days of age, when specificity was 93%. Neither sensitivity nor specificity was significantly affected by maternal or infant zidovudine (ZDV) treatment, even though infant viral loads were lower during the first 6 weeks in infants who received perinatal ZDV prophylaxis ( p=.005). Paired analysis of DNA and RNA measurements revealed no advantage for either test. Quantitative RNA testing can be used for diagnosis in HIV-exposed infants, recognizing the chance for a false-positive test result. It may be most useful as a confirmatory test in infants with another positive diagnostic test result. |
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