RNA Viral Load Test for Early Diagnosis of Vertical Transmission of HIV-1 Infection

Souza, Inara E.; Azevedo, Maria Lúcia; Succi, Regina C.M.; Machado, Daisy Maria; Diaz, Ricardo S.

doi:10.1097/00126334-200004010-00015

Cited by 9 publications

(3 citation statements)

References 10 publications

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“…These assays are available as "standard" or "ultrasensitive" assays, and the lower limit of detection possible when using the ultrasensitive assays is in the range of 50 to 75 HIV-1 copies per mL of plasma. Numerous studies of the use of HIV-1 RNA assays for the diagnosis of HIV-1 infection in pediatric populations have been conducted, 52,59,[65][66][67][68][69][70][71][72][73][74][75] with the reported sensitivity of testing (Table 3) for such assays ranging from 25% to 50% within the first few days of life to 100% by 6 to 12 weeks of age. 65,67 HIV-1 RNA assays have been assessed to be at least as sensitive as, or more sensitive than, HIV-1 DNA assays among young infants.…”

Section: Hiv-1 Naatsmentioning

confidence: 99%

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

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2007

Pediatrics

120

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The objectives of this technical report are to describe methods of diagnosis of HIV-1 infection in children younger than 18 months in the United States and to review important issues that must be considered by clinicians who care for infants and young children born to HIV-1–infected women. Appropriate HIV-1 diagnostic testing for infants and children younger than 18 months differs from that for older children, adolescents, and adults because of passively transferred maternal HIV-1 antibodies, which may be detectable in the child's bloodstream until 18 months of age. Therefore, routine serologic testing of these infants and young children is generally only informative before the age of 18 months if the test result is negative. Virologic assays, including HIV-1 DNA or RNA assays, represent the gold standard for diagnostic testing of infants and children younger than 18 months. With such testing, the diagnosis of HIV-1 infection (as well as the presumptive exclusion of HIV-1 infection) can be established within the first several weeks of life among nonbreastfed infants. Important factors that must be considered when selecting HIV-1 diagnostic assays for pediatric patients and when choosing the timing of such assays include the age of the child, potential timing of infection of the child, whether the infection status of the child's mother is known or unknown, the antiretroviral exposure history of the mother and of the child, and characteristics of the virus. If the mother's HIV-1 serostatus is unknown, rapid HIV-1 antibody testing of the newborn infant to identify HIV-1 exposure is essential so that antiretroviral prophylaxis can be initiated within the first 12 hours of life if test results are positive. For HIV-1–exposed infants (identified by positive maternal test results or positive antibody results for the infant shortly after birth), it has been recommended that diagnostic testing with HIV-1 DNA or RNA assays be performed within the first 14 days of life, at 1 to 2 months of age, and at 3 to 6 months of age. If any of these test results are positive, repeat testing is recommended to confirm the diagnosis of HIV-1 infection. A diagnosis of HIV-1 infection can be made on the basis of 2 positive HIV-1 DNA or RNA assay results. In nonbreastfeeding children younger than 18 months with no positive HIV-1 virologic test results, presumptive exclusion of HIV-1 infection can be based on 2 negative virologic test results (1 obtained at ≥2 weeks and 1 obtained at ≥4 weeks of age); 1 negative virologic test result obtained at ≥8 weeks of age; or 1 negative HIV-1 antibody test result obtained at ≥6 months of age. Alternatively, presumptive exclusion of HIV-1 infection can be based on 1 positive HIV-1 virologic test with at least 2 subsequent negative virologic test results (at least 1 of which is performed at ≥8 weeks of age) or negative HIV-1 antibody test results (at least 1 of which is performed at ≥6 months of age). Definitive exclusion of HIV-1 infection is based on 2 negative virologic test results, 1 obtained at ≥1 month of age and 1 obtained at ≥4 months of age, or 2 negative HIV-1 antibody test results from separate specimens obtained at ≥6 months of age. For both presumptive and definitive exclusion of infection, the child should have no other laboratory (eg, no positive virologic test results) or clinical (eg, no AIDS-defining conditions) evidence of HIV-1 infection. Many clinicians confirm the absence of HIV-1 infection with a negative HIV-1 antibody assay result at 12 to 18 months of age. For breastfeeding infants, a similar testing algorithm can be followed, with timing of testing starting from the date of complete cessation of breastfeeding instead of the date of birth.

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Section: Hiv-1 Naatsmentioning

confidence: 99%

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Read¹

2007

Pediatrics

120

View full text Add to dashboard Cite

show abstract

“…[22] In the peripartum transmission, however, the presence of viruses will occur in general around two weeks after birth. [23] Other feature that needs to be taken into account relates to the viral dynamics of HIV-replication among children infected by the vertical route. Whereas among adults, viral load in general reaches the set point by 6 month after HIV infection, [24] and mean basal viral load is inferior to 100,000 RNA copies/mL, children will take much longer to show a week control of viremia after primary infection.…”

Section: B Nucleic Acid Testing During the Immunologic Window Periodmentioning

confidence: 99%

“…When those tests are performed in children using samples collected after 3 weeks of deliver, the sensitivity, specificity, positive and negative predictive value can be all 100%. [23] …”

Section: B Nucleic Acid Testing During the Immunologic Window Periodmentioning

confidence: 99%

Nucleic Acid Testing for HIV-1 Diagnosis and Monitoring

Diaz¹

2012

HIV Testing

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Biological function of a novel chrysovirus, CnV1-BS122, in the Korean Cryphonectria nitschkei BS122 strain

Kim

Jung

Park

et al. 2013

Journal of Bioscience and Bioengineering

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RNA Viral Load Test for Early Diagnosis of Vertical Transmission of HIV-1 Infection

Cited by 9 publications

References 10 publications

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Diagnosis of HIV-1 Infection in Children Younger Than 18 Months in the United States

Nucleic Acid Testing for HIV-1 Diagnosis and Monitoring

Biological function of a novel chrysovirus, CnV1-BS122, in the Korean Cryphonectria nitschkei BS122 strain

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