Use of the polymerase chain reaction for early detection of the proviral sequences of human immunodeficiency virus in infants born to seropositive mothers

M. F. Rogers, C. Y. Ou, M. Rayfield, P. A. Thomas, Ellie Schoenbaum, E. Abrams, K. Krasinski, Peter A. Selwyn, J. Moore, A. Kaul, K. T. Grimm, M. Bamji, G. Schochetman

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Abstract

The early diagnosis of infection with human immunodeficiency virus (HIV) in infants born to infected mothers is essential for early treatment, but current tests cannot detect HIV infection in newborns because of the presence of maternal antibodies. We used the polymerase chain reaction, a new technique that amplifies proviral sequences of HIV within DNA, to detect HIV infection in peripheral-blood mononuclear cells obtained from infants of seropositive women during the neonatal (age less than 28 days) and postneonatal periods. In blood obtained during the neonatal period, the polymerase chain reaction was positive in five of seven infants in whom the acquired immunodefiency syndrome (AIDS) later developed (a mean of 9.8 months after the test). The test was also positive in one of eight newborns who later had nonspecific signs and symptoms suggestive of HIV infection (mean follow-up, 12 months). No proviral sequences were detected in neonatal samples from nine infants who remained well (mean follow-up, 16 months). HIV proviral sequences were detected in samples obtained during the postneonatal period (median age, five months) in all of 6 infants tested who later had AIDS and in 4 of 14 infants with nonspecific findings suggestive of HIV infection. No proviral sequences were detected in 25 infants who remained well (mean follow-up, 17 months) after being born to HIV-seropositive mothers, or in 15 infants born to HIV-seronegative mothers. We conclude that the polymerase chain reaction will be a useful technique to diagnose HIV infection in newborns and to predict the subsequent development of AIDS. However, larger studies will be required to determine the sensitivity and specificity of the test.

Original languageEnglish (US)
Pages (from-to)1649-1654
Number of pages6
JournalNew England Journal of Medicine
Volume320
Issue number25
StatePublished - 1989

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Mothers
HIV
Polymerase Chain Reaction
Virus Diseases
Newborn Infant
Signs and Symptoms
Early Diagnosis
Blood Cells
Sensitivity and Specificity
Antibodies
DNA
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Use of the polymerase chain reaction for early detection of the proviral sequences of human immunodeficiency virus in infants born to seropositive mothers. / Rogers, M. F.; Ou, C. Y.; Rayfield, M.; Thomas, P. A.; Schoenbaum, Ellie; Abrams, E.; Krasinski, K.; Selwyn, Peter A.; Moore, J.; Kaul, A.; Grimm, K. T.; Bamji, M.; Schochetman, G.

In: New England Journal of Medicine, Vol. 320, No. 25, 1989, p. 1649-1654.

Research output: Contribution to journalArticle

Rogers, MF, Ou, CY, Rayfield, M, Thomas, PA, Schoenbaum, E, Abrams, E, Krasinski, K, Selwyn, PA, Moore, J, Kaul, A, Grimm, KT, Bamji, M & Schochetman, G 1989, 'Use of the polymerase chain reaction for early detection of the proviral sequences of human immunodeficiency virus in infants born to seropositive mothers', New England Journal of Medicine, vol. 320, no. 25, pp. 1649-1654.
Rogers, M. F. ; Ou, C. Y. ; Rayfield, M. ; Thomas, P. A. ; Schoenbaum, Ellie ; Abrams, E. ; Krasinski, K. ; Selwyn, Peter A. ; Moore, J. ; Kaul, A. ; Grimm, K. T. ; Bamji, M. ; Schochetman, G. / Use of the polymerase chain reaction for early detection of the proviral sequences of human immunodeficiency virus in infants born to seropositive mothers. In: New England Journal of Medicine. 1989 ; Vol. 320, No. 25. pp. 1649-1654.
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N2 - The early diagnosis of infection with human immunodeficiency virus (HIV) in infants born to infected mothers is essential for early treatment, but current tests cannot detect HIV infection in newborns because of the presence of maternal antibodies. We used the polymerase chain reaction, a new technique that amplifies proviral sequences of HIV within DNA, to detect HIV infection in peripheral-blood mononuclear cells obtained from infants of seropositive women during the neonatal (age less than 28 days) and postneonatal periods. In blood obtained during the neonatal period, the polymerase chain reaction was positive in five of seven infants in whom the acquired immunodefiency syndrome (AIDS) later developed (a mean of 9.8 months after the test). The test was also positive in one of eight newborns who later had nonspecific signs and symptoms suggestive of HIV infection (mean follow-up, 12 months). No proviral sequences were detected in neonatal samples from nine infants who remained well (mean follow-up, 16 months). HIV proviral sequences were detected in samples obtained during the postneonatal period (median age, five months) in all of 6 infants tested who later had AIDS and in 4 of 14 infants with nonspecific findings suggestive of HIV infection. No proviral sequences were detected in 25 infants who remained well (mean follow-up, 17 months) after being born to HIV-seropositive mothers, or in 15 infants born to HIV-seronegative mothers. We conclude that the polymerase chain reaction will be a useful technique to diagnose HIV infection in newborns and to predict the subsequent development of AIDS. However, larger studies will be required to determine the sensitivity and specificity of the test.

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