AEGiS-14IAC: Incorporation of the Nuclisens HIV RNA qualitative (QL) assay in the early diagnosis of pediatric HIV infection.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Incorporation of the Nuclisens HIV RNA qualitative (QL) assay in the early diagnosis of pediatric HIV infection.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10218)

Canizal AM, Fernandez Giuliano S, Zapiola I, Multare S, Bouzas MB
Hospital Francisco Javier Muniz, Ciudad de Buenos Aires, Argentina

BACKGROUND: Previous reports have demonstrated that high viral RNA levels are detected in plasma inmediately after infection both in adults and infants. The sensitivity of the Roche Amplicor HIV-1 DNA assay has been reported to be 54.5% for infants younger than 48hs and 95% for those older than 1 month. The objective of the present study was to evaluate the utility of the RNA QL assay for the early diagnosis of HIV infection.

METHODS: 67 infants born to HIV-seropositive mothers in whom at least 2 samples were subsequent collected were included for the present analysis. Samples were tested for the presence of viral RNA in plasma (Nuclisens HIV-1 QL Organon, detection limit: 50 copies/ml), DNA (Roche Amplicor HIV-1) and p24Ag (Coulter) after inmunocomplex dissociation. All assays were performed following manufacters instructions.

RESULTS: Table shows the different markers at the time of the first sample. [table: see text]The median time between first and second sample was 61 days. 13/67 infants were infected, 11/13 were found to be RNA and DNA positive in subsequent samples. In 2/13 the RNA and the p24 Ag were consistently positive but the DNA was negative in both samples. In 7/13 the diagnosis was arised at the age of 2 month, and in 2 cases at the age of 20 days. In the latest 2 cases is important to remark that the QL assay showed more sensitivity than the DNA assay at the time of the first sample, 24 hs and 8 days respectively.

CONCLUSIONS: The RNA QL assay showed greater sensitivity than the DNA assay in newborn infants. No false positive were detected. The false negative detected in the DNA assay could be associated with non-B subtype specimens since previous reports have shown that the Roche DNA assay has a diminished sensitivity for them. These preliminary results suggests that the inclusion of the qualitative HIV RNA assay together with the DNA assay allows an early diagnosis of HIV infection specially in infants younger than 1 month.

Keywords: AEGIS, HIV Infections, HIV-1, HIV Seropositivity, RNA, Viral, Sensitivity and Specificity, Adult, Human, Infant, Infant, Newborn, Child

020707
B10218