Comparison of human immunodeficiency virus 1 DNA polymerase chain reaction and qualitative and quantitative RNA polymerase chain reaction in human immunodeficiency virus 1-exposed infants

Abstract

HIV-1 RNA PCR may offer a slight advantage in sensitivity over DNA PCR in the diagnosis of HIV infection in young infants. Positive RNA results can be found in a small number of infants who are not HIV-1-infected. HIV-1 RNA detection should not be routinely used alone for the diagnosis of HIV infection in young infants.

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

“…51,56,59 Similarly high specificity has been observed by 1 month of age in nonbreastfed infants. 51,55,56,59 HIV-1 RNA Assays HIV-1 RNA assays detect plasma (cell-free) viral RNA by using different techniques. Methods of amplification of HIV-1 RNA include target (nucleic acid sequence-based amplification and reversetranscriptase PCR) and signal (branched-chain DNA) amplification techniques.…”

“…65,67 HIV-1 RNA assays have been assessed to be at least as sensitive as, or more sensitive than, HIV-1 DNA assays among young infants. 52,59,[66][67][68]71 Similarly high specificity by 6 to 12 weeks of age (as compared with HIV-1 DNA assays or HIV-1 culture) has been observed among nonbreastfed infants. 52,59,65,68,72 HIV-1 RNA assays are now commonly used to diagnose HIV-1 infection in infants.…”

“…52,59,[66][67][68]71 Similarly high specificity by 6 to 12 weeks of age (as compared with HIV-1 DNA assays or HIV-1 culture) has been observed among nonbreastfed infants. 52,59,65,68,72 HIV-1 RNA assays are now commonly used to diagnose HIV-1 infection in infants. HIV-1 RNA assays are often more readily available than HIV-1 DNA assays because of the common use of RNA assays in follow-up testing of patients during treatment for HIV-1 infection.…”

“…The sensitivity of HIV-1 DNA assays for the diagnosis of HIV-1 infection in infants and young children has been evaluated (Table 2) in several studies 51,52,[55][56][57][58][59][60][61][62] and meta-analyses, 63,64 with estimates as high as 90% to 100% by 1 month of age. 51,56,59 Similarly high specificity has been observed by 1 month of age in nonbreastfed infants. 51,55,56,59 HIV-1 RNA Assays HIV-1 RNA assays detect plasma (cell-free) viral RNA by using different techniques.…”

“…These assays are available as "standard" or "ultrasensitive" assays, and the lower limit of detection possible when using the ultrasensitive assays is in the range of 50 to 75 HIV-1 copies per mL of plasma. Numerous studies of the use of HIV-1 RNA assays for the diagnosis of HIV-1 infection in pediatric populations have been conducted, 52,59,[65][66][67][68][69][70][71][72][73][74][75] with the reported sensitivity of testing (Table 3) for such assays ranging from 25% to 50% within the first few days of life to 100% by 6 to 12 weeks of age. 65,67 HIV-1 RNA assays have been assessed to be at least as sensitive as, or more sensitive than, HIV-1 DNA assays among young infants.…”