[A comparative study of technics for the diagnosis of the human immunodeficiency virus in infants under 15 months by: viral cultivation, the polymerase chain reaction and antigen p24].

The objective of this study was to compare the polymerase chain reaction (PCR), virus culture (VC) and antigen detection (AG), assays which can be used for the early diagnosis of vertically transmitted HIV-1 infection in infants under 15 months of age, when a diagnosis cannot be based on seropositivity because of maternal antibody persistence. Thirty-nine children born to HIV-1-seropositive mothers were evaluated by the three techniques. The children were then followed to at least 18 months of age. The p24 antigen was measured in plasma and HIV proviral DNA was determined in peripheral blood mononuclear cells after amplification by PCR. Prime pairs from three different regions of the proviral genome were used for the PCR tests. We found that in the first evaluation, 15 (100%) of the children who later developed clinical symptoms were positive by PCR analysis, 14 (93.3%) by the initial VC assay and only 8 (53.3%) by the p24 antigen assay. In conclusion, PCR and VC assays were found to have higher sensitivity than the p24 antigen assay for the diagnosis of HIV-1 infection. In addition, p24 antigenaemia was shown to be useful in predicting the onset of the disease. This study shows that the PCR test represents a more reliable and faster alternative to viral culture for the diagnosis of pediatric HIV infection.