       Document 0526
 DOCN  M9640526
 TI    The sensitivity of HIV-1 DNA polymerase chain reaction in the neonatal
       period and the relative contributions of intra-uterine and intra-partum
       transmission.
 DT    9604
 AU    Dunn DT; Brandt CD; Krivine A; Cassol SA; Roques P; Borkowsky W; De
       Rossi A; Denamur E; Ehrnst A; Loveday C; et al; Department of
       Epidemiology and Biostatics, Institute of Child; Health, London, UK.
 SO    AIDS. 1995 Sep;9(9):F7-11. Unique Identifier : AIDSLINE MED/96085711
 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       unpublished PCR test results on prospectively followed, non-breastfed,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.
 DE    *Disease Transmission, Vertical  DNA, Viral/*GENETICS  Female  Human
       HIV Infections/DIAGNOSIS/*TRANSMISSION/VIROLOGY  HIV-1/*GENETICS
       Infant, Newborn  *Polymerase Chain Reaction  Predictive Value of Tests
       Pregnancy  Pregnancy Complications, Infectious/*DIAGNOSIS/VIROLOGY
       Prospective Studies  Sensitivity and Specificity  Support, Non-U.S.
       Gov't  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

