Document 0824
 DOCN  M9650824
 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    9605
 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

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