Affililations: *Department of Pediatrics, Chiang Rai Hospital
**Virus Reseach Institute, Department of Medical Sciences, Ministry
of Public Health
Source: Thai Journal of Pediatrics 1997; 36(3): 179-189
Language: Thai with English abstract
Background: Early diagnosis of vertically acquired HIV infection has important implications for decisions concerning initiation of prophylactic and therapeutic medications and helps in informing parents. But conventional HIV serologic tests are not useful because of the confounding presence of maternal antibody. Direct detection of HIV DNA by polymerase chain reaction (PCR) may be necessary for diagnosis of HIV infection during early infancy
Objectives: To determine perinatal HIV transmission rate in Chiang Rai by PCR during first 6 months and the value of this technique for detecting HIV infection during early infancy
Methods: During October 1993 to July 1994, 130 bottlefed infants born to seropositive mothers in Chiang Rai Hospital were enrolled for prospective followup. The HIV infection status was determined using two separate positive PCR results during first 6 months, and correlated with clinically diagnosis by WHO criteria or seropositive at 18 months.
Results: Ninety-nine (76%) infants had known infection status. Of these, 25 were HIV infected by positive PCR during first 6 months. The perinatal transmission rate revealed 25.2% (95% CI, 17.4-33.1). After 18 months, 13 infants (13%) met the modified WHO pediatric AIDS definition. Seven infants (7%) were symptomatic HIV infection and one infant was seropositive but remained asymptomatic. All of these 21 infants had positive PCR during first 6 months. The other 4 positive PCR infants and all of negative PCR group were seroreverted and free of symptoms. The sensitivity and specificity of PCR for diagnosis of HIV infection during the first 6 months of life were 100% and 95%, respectively.
Conclusions: Our study reports the reduction of perinatal HIV transmission rate in Chiang Rai and shows that PCR will be helpful for diagnosis of HIV infection in early infancy.