Nesheim S, Lee F, Kalish M L, Ou C Y, Sawyer M, Clark S, Meadows L, Grimes V, Simonds R J, Nahmias A
Department of Pediatrics, Emory University School of Medicine, and Centers for Disease Control and Prevention, Atlanta, Georgia 30335, USA.
J Infect Dis. 1997 Jun;175(6):1333-6. doi: 10.1086/516464.
Results of polymerase chain reaction (PCR) and p24 antigen detection after immune complex dissociation (p24-ICD) were compared with antibody results after 18 months of age for human immunodeficiency virus (HIV) diagnosis in 345 prospectively followed, perinatally exposed infants. Of 59 infected and 286 uninfected infants tested at 1-6 months of age, sensitivity and specificity were, respectively, 100% and > 97% for PCR and 90% and > 97% for p24-ICD. Testing was done on > or = 2 occasions in the first 6 months of life in 43 infected infants; 77% had > or = 2 positive results with the same test. Of these infants, 68% had 2 positive p24-ICD tests. In uninfected infants, 96% had only negative tests; none had > 1 positive. By 6 months, all uninfected infants with > or = 2 PCR results could have been diagnosed. HIV status can be determined by PCR by age 6 months in most HIV-exposed infants. p24-ICD should not be used alone, because of its lower sensitivity, but may be useful in areas without advanced laboratory support.
对345名前瞻性随访的围产期暴露婴儿进行了18个月龄后免疫复合物解离后聚合酶链反应（PCR）和p24抗原检测（p24-ICD）结果与抗体结果的比较，以诊断人类免疫缺陷病毒（HIV）。在1至6个月龄检测的59名感染婴儿和286名未感染婴儿中，PCR的敏感性和特异性分别为100%和>97%，p24-ICD的敏感性和特异性分别为90%和>97%。43名感染婴儿在生命的前6个月进行了≥2次检测；77%的婴儿同一项检测有≥2次阳性结果。在这些婴儿中，68%的婴儿p24-ICD检测有2次阳性结果。在未感染婴儿中，96%的婴儿检测结果均为阴性；无一例有>1次阳性结果。到6个月时，所有有≥2次PCR结果的未感染婴儿均可被诊断。在大多数暴露于HIV的婴儿中，6个月龄时可通过PCR确定HIV状态。由于p24-ICD敏感性较低，不应单独使用，但在没有先进实验室支持的地区可能有用。
