TY - JOUR
T1 - Use of the Polymerase Chain Reaction for Early Detection of the Proviral Sequences of Human Immunodeficiency Virus in Infants Born to Seropositive Mothers
AU - New York City Collaborative Study of Maternal HIV Transmission and Montefiore Medical Center HIV Perinatal Transmission Study Group
AU - Rogers, Martha F.
AU - ou, Chin Yih
AU - Rayfield, Mark
AU - Thomas, Pauline A.
AU - Schoenbaum, Ellie E.
AU - Abrams, Elaine
AU - Krasinski, Keith
AU - Selwyn, Peter A.
AU - Moore, Jennifer
AU - Kaul, Aditya
AU - Grimm, Katherine T.
AU - Bamji, Mahrukh
AU - Schochetman, Gerald
PY - 1989/6/22
Y1 - 1989/6/22
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 immunodeficiency 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. STUDIES have shown that 30 to 50 percent of the infants born to women with human immunodeficiency virus (HIV) infection will acquire the virus from their mothers in utero, during labor and delivery, or post partum through breast-feeding.1 2 3 4 5 6 The diagnosis of HIV infection in infants has been hampered by the presence of passively acquired maternal antibody, the difficulty in performing viral culture, the lack of reliable tests for HIV-specific IgM, and the presence of nonspecific signs and symptoms of HIV infection in infants. In addition, serum antigen is usually not detected when excess serum antibody is present, as in infants…
AB - 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 immunodeficiency 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. STUDIES have shown that 30 to 50 percent of the infants born to women with human immunodeficiency virus (HIV) infection will acquire the virus from their mothers in utero, during labor and delivery, or post partum through breast-feeding.1 2 3 4 5 6 The diagnosis of HIV infection in infants has been hampered by the presence of passively acquired maternal antibody, the difficulty in performing viral culture, the lack of reliable tests for HIV-specific IgM, and the presence of nonspecific signs and symptoms of HIV infection in infants. In addition, serum antigen is usually not detected when excess serum antibody is present, as in infants…
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U2 - 10.1056/NEJM198906223202503
DO - 10.1056/NEJM198906223202503
M3 - Article
C2 - 2725615
AN - SCOPUS:0024311306
SN - 0028-4793
VL - 320
SP - 1649
EP - 1654
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 25
ER -