Paul M O, Tetali S, Lesser M L, Abrams E J, Wang X P, Kowalski R, Bamji M, Napolitano B, Gulick L, Bakshi S
Department of Pediatrics, North Shore University Hospital-Cornell University Medical College, Manhasset, NY 11030, USA.
J Infect Dis. 1996 Jan;173(1):68-76. doi: 10.1093/infdis/173.1.68.
Accurate and timely diagnosis of infection status in infants born to women infected with human immunodeficiency virus (HIV) is of paramount importance. The comparative accuracy of five diagnostic decision rules was evaluated in 208 HIV-exposed infants (32 infected, 176 uninfected) based on laboratory testing during the first 6 months of life. Diagnostic rules A and B, which required single blood samples analyzed by culture and polymerase chain reaction (PCR) (rule A) or culture, PCR, and p24 antigen detection (rule B) were more prone to incorrect diagnoses than were rules requiring 2 blood samples analyzed by a single assay (rule C) or combinations of culture and PCR (rules D and E). Rule D, which used PCR as the initial test, established the most useful algorithm: a positive PCR result followed by a positive culture in the second sample confirmed infected status, while two consecutive negative PCR results reconfirmed as negative at 6 months of age established uninfected status.
准确及时地诊断感染人类免疫缺陷病毒（HIV）的女性所生婴儿的感染状况至关重要。基于出生后头6个月的实验室检测，对208名暴露于HIV的婴儿（32名感染，176名未感染）评估了五种诊断决策规则的相对准确性。诊断规则A和B，即需要通过培养和聚合酶链反应（PCR）分析单个血样（规则A）或培养、PCR和p24抗原检测（规则B），比需要通过单一检测分析两份血样的规则（规则C）或培养与PCR组合的规则（规则D和E）更容易出现误诊。以PCR作为初始检测的规则D建立了最有用的算法：PCR结果呈阳性，随后第二个样本培养结果呈阳性，确认感染状态；而连续两次PCR结果均为阴性，并在6个月大时再次确认为阴性，则确定未感染状态。
