Laboratoire de Virologie, Hôpital Necker, AP-HP, Paris, France.
J Pediatr. 2012 Jan;160(1):60-6.e1. doi: 10.1016/j.jpeds.2011.06.053. Epub 2011 Aug 24.
To compare performance of testing for human immunodeficiency virus (HIV)-1 DNA and HIV-1 RNA for diagnosis of HIV-1 infection in infants receiving preventive antiretroviral therapy.
This substudy of the French multicenter prospective cohort of neonates born to HIV-infected mothers, included 1567 infants tested for HIV with polymerase chain reaction (PCR) in a single laboratory, receiving post-natal prophylaxis, not breastfed, and having simultaneous HIV-1 DNA and RNA results before 45 days. The performance of PCR was assessed in reference to the 6-month HIV-1 RNA result.
Specificity of both HIV-1 RNA and HIV-1 DNA PCR was 100% at all ages (except 99.8% for DNA at birth); sensitivity was 58% (RNA) and 55% (DNA) at birth, and 89% at 1 month, 100% at 3 months for both, and 100% at 6 months (DNA). Concordance between HIV-1 DNA and RNA results was 0.78 and 0.81 (Kappa) at birth and 1 month and 100% at 3 and 6 months. Type of maternal and neonatal prophylaxis had no effect on sensitivity, but influenced viral load.
The performances of testing for HIV-1 DNA and RNA were similar with 100% sensitivity at 3 months. At 1 month during prophylaxis, 11% of infected children had negative PCR results.
比较检测人类免疫缺陷病毒（HIV）-1 DNA 和 HIV-1 RNA 在接受预防抗逆转录病毒治疗的婴儿中诊断 HIV-1 感染的性能。
这是法国多中心前瞻性队列研究的一个子研究，该研究纳入了 1567 名接受产后预防、未母乳喂养且在 45 天内同时具有 HIV-1 DNA 和 RNA 结果的 HIV 感染母亲所生的新生儿，用聚合酶链反应（PCR）进行 HIV 检测。以 6 个月时 HIV-1 RNA 结果为参照，评估 PCR 的性能。
在所有年龄段，HIV-1 RNA 和 HIV-1 DNA PCR 的特异性均为 100%（除了 DNA 在出生时为 99.8%）；出生时的敏感性分别为 58%（RNA）和 55%（DNA），1 个月时为 89%，3 个月时均为 100%，6 个月时为 100%（DNA）。HIV-1 DNA 和 RNA 结果之间的一致性在出生和 1 个月时为 0.78 和 0.81（Kappa），在 3 个月和 6 个月时为 100%。母亲和新生儿预防的类型对敏感性没有影响，但影响病毒载量。
检测 HIV-1 DNA 和 RNA 的性能相似，在 3 个月时具有 100%的敏感性。在预防期间的 1 个月时，11%的感染儿童 PCR 结果为阴性。
