Comeau A M, Pitt J, Hillyer G V, Landesman S, Bremer J, Chang B H, Lew J, Moye J, Grady G F, McIntosh K
Theobald Smith Research Institute, Inc., New England Regional Newborn Screening Program, Jamaica Plain, Massachusetts, USA.
J Pediatr. 1996 Jul;129(1):111-8. doi: 10.1016/s0022-3476(96)70197-x.
To evaluate the use of dried blood spot (DBS) specimens and the early diagnostic value of the polymerase chain reaction (PCR) for detection of the human immunodeficiency virus (HIV) in DBS specimens collected at predefined age intervals from a large cohort of U.S. infants at risk of congenital or perinatal HIV infection.
We assayed available DBS specimens (n = 272) obtained during the first 4 months of life from 144 infants (41 infected, 103 uninfected) born to HIV-infected mothers enrolled in the Women and Infants Transmission Study. The DBS PCR results were compared with infant HIV infection status, PCR on liquid blood, and viral culture results. Analyses also included sensitivity and specificity of assay as related to the age of the infant when the specimen was obtained.
The DBS specimen PCR results were concordant with results from liquid blood specimens and with results from viral culture. The DBS PCR was highly specific for all age groups. Sensitivity in detecting HIV infection status rapidly increased during the first month of life, from 19% (5/26) by 1 week to 96% (25/26) by 1 month of age. Specimens obtained on the day of birth or the next day were the least likely to have detectable HIV DNA.
The PCR assay of DBS specimens is a reliable tool for the early diagnosis of HIV infection and has important advantage over that of liquid blood DNA PCR and viral culture. These advantages include a lower volume of blood required for testing, increased safety, and ease of storage or transport of specimens. Thus DBS PCR is a useful test for clinical and epidemiologic tracking of infants at risk of HIV infection.
评估干血斑（DBS）标本的使用情况以及聚合酶链反应（PCR）对在美国一大群有先天性或围产期HIV感染风险的婴儿中，按预定年龄间隔采集的DBS标本进行人类免疫缺陷病毒（HIV）检测的早期诊断价值。
我们检测了从参与母婴传播研究的感染HIV的母亲所生的144名婴儿（41名感染，103名未感染）出生后前4个月内获得的可用DBS标本（n = 272）。将DBS PCR结果与婴儿HIV感染状况、液体血液PCR结果以及病毒培养结果进行比较。分析还包括检测与获取标本时婴儿年龄相关的检测灵敏度和特异性。
DBS标本PCR结果与液体血液标本结果以及病毒培养结果一致。DBS PCR对所有年龄组都具有高度特异性。在出生后第一个月内，检测HIV感染状况的灵敏度迅速增加，从1周时的19%（5/26）增加到1月龄时的96%（25/26）。出生当天或第二天采集的标本检测到HIV DNA的可能性最小。
DBS标本的PCR检测是早期诊断HIV感染的可靠工具，与液体血液DNA PCR和病毒培养相比具有重要优势。这些优势包括检测所需血量更少、安全性提高以及标本储存或运输更方便。因此，DBS PCR对于对有HIV感染风险的婴儿进行临床和流行病学追踪是一种有用的检测方法。
