Abstract
Objective: To derive reliable estimates of the sensitivity of HIV-1 DNA polymerase chain reaction (PCR) in the neonatal period and to quantify the relative contributions of intra-uterine and intra-partum transmission. Methods: After reviewing studies on the early diagnosis of HIV-1 infection, investigators were asked to provide published and unpublished PCR test results on prospectively followed, non-breastfed, vertically infected children. Age-specific estimates of the sensitivity of PCR were derived using distribution-free methods for interval-censored data. Results: Data on 271 infected children were combined for analysis. PCR detected HIV-1 DNA in an estimated 38% [90% confidence interval (CI), 29-46] of HIV-infected children tested on the day of, or day after, birth. Sensitivity was observed to rise rapidly in the second week of life, reaching 93% (90% CI, 76-97) by 14 days of age. Conclusion: The sensitivity of PCR in the neonatal period is higher than previously reported. This affects the clinical interpretation of an early negative test result and encourages the use of PCR as an endpoint for trials to evaluate interventions to reduce vertical transmission in non-breastfed populations. Approximately one-third of vertically acquired HIV-1 infection could be attributable to intra-uterine transmission.
| Original language | English |
|---|---|
| Journal | AIDS (London, England) |
| Volume | 9 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - Sep 1995 |
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Keywords
- Polymerase chain reaction
- Sensitivity
- Timing of transmission
- Vertical transmission
ASJC Scopus subject areas
- Immunology and Allergy
- Immunology
Cite this
The sensitivity of HIV-1 DNA polymerase chain reaction in the neonatal period and the relative contributions of intra-uterine and intra-partum transmission. / Dunn, David T.; Brandt, Carl D.; Krivine, Anne; Cassol, Sharon A.; Roques, Pierre; Borkowsky, William; De Rossi, Anita; Denamur, Erick; Ehrnst, Anneka; Loveday, Clive; Harris, Jo Ann; McIntosh, Kenneth; Comeau, Anne Marie; Rakusan, Tamara; Newell, Marie Louise; Peckham, Catherine S.
In: AIDS (London, England), Vol. 9, No. 9, 09.1995.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The sensitivity of HIV-1 DNA polymerase chain reaction in the neonatal period and the relative contributions of intra-uterine and intra-partum transmission
AU - Dunn, David T.
AU - Brandt, Carl D.
AU - Krivine, Anne
AU - Cassol, Sharon A.
AU - Roques, Pierre
AU - Borkowsky, William
AU - De Rossi, Anita
AU - Denamur, Erick
AU - Ehrnst, Anneka
AU - Loveday, Clive
AU - Harris, Jo Ann
AU - McIntosh, Kenneth
AU - Comeau, Anne Marie
AU - Rakusan, Tamara
AU - Newell, Marie Louise
AU - Peckham, Catherine S.
PY - 1995/9
Y1 - 1995/9
N2 - Objective: To derive reliable estimates of the sensitivity of HIV-1 DNA polymerase chain reaction (PCR) in the neonatal period and to quantify the relative contributions of intra-uterine and intra-partum transmission. Methods: After reviewing studies on the early diagnosis of HIV-1 infection, investigators were asked to provide published and unpublished PCR test results on prospectively followed, non-breastfed, vertically infected children. Age-specific estimates of the sensitivity of PCR were derived using distribution-free methods for interval-censored data. Results: Data on 271 infected children were combined for analysis. PCR detected HIV-1 DNA in an estimated 38% [90% confidence interval (CI), 29-46] of HIV-infected children tested on the day of, or day after, birth. Sensitivity was observed to rise rapidly in the second week of life, reaching 93% (90% CI, 76-97) by 14 days of age. Conclusion: The sensitivity of PCR in the neonatal period is higher than previously reported. This affects the clinical interpretation of an early negative test result and encourages the use of PCR as an endpoint for trials to evaluate interventions to reduce vertical transmission in non-breastfed populations. Approximately one-third of vertically acquired HIV-1 infection could be attributable to intra-uterine transmission.
AB - Objective: To derive reliable estimates of the sensitivity of HIV-1 DNA polymerase chain reaction (PCR) in the neonatal period and to quantify the relative contributions of intra-uterine and intra-partum transmission. Methods: After reviewing studies on the early diagnosis of HIV-1 infection, investigators were asked to provide published and unpublished PCR test results on prospectively followed, non-breastfed, vertically infected children. Age-specific estimates of the sensitivity of PCR were derived using distribution-free methods for interval-censored data. Results: Data on 271 infected children were combined for analysis. PCR detected HIV-1 DNA in an estimated 38% [90% confidence interval (CI), 29-46] of HIV-infected children tested on the day of, or day after, birth. Sensitivity was observed to rise rapidly in the second week of life, reaching 93% (90% CI, 76-97) by 14 days of age. Conclusion: The sensitivity of PCR in the neonatal period is higher than previously reported. This affects the clinical interpretation of an early negative test result and encourages the use of PCR as an endpoint for trials to evaluate interventions to reduce vertical transmission in non-breastfed populations. Approximately one-third of vertically acquired HIV-1 infection could be attributable to intra-uterine transmission.
KW - Polymerase chain reaction
KW - Sensitivity
KW - Timing of transmission
KW - Vertical transmission
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U2 - 10.1097/00002030-199509000-00001
DO - 10.1097/00002030-199509000-00001
M3 - Article
VL - 9
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 9
ER -