Efficacy of HIV PCR techniques to diagnose HIV in infants born to HIV infected mothers--an Indian perspective.

AIM To determine the efficiency of HIV DNA PCR (qualitative) and HIV RNA PCR (quantitative) to detect or rule out HIV infection in infants born to HIV infected mothers. SETTING Pediatric and perinatal HIV clinic in a tertiary pediatric hospital. STUDY DESIGN Prospective study METHODS AND MATERIALS 52 infants born to HIV positive mother were tested for HIV infection by HIV DNA PCR or HIV-1 viral load from 1.5 to 7 months of age. Their HIV status was confirmed by an HIV ELISA test at 18 months of age. RESULTS Of the 36 patients tested by HIV DNA PCR test, 15 patients (41.8%) had a positive test and 21 patients (58.2%) had a negative test. 12 patients (80%) had a false positive test (80%) and no patient had a false negative test. Sensitivity of HIV DNA test 100% with specificity of 53.9%. Of the 18 patients tested by HIV viral load, 17 patients (94.4%) had a negative test and 1 patient (5.6%) had a positive test. No patient had a false negative or false positive test. Sensitivity and specificity of HIV viral load was 100%, which was statistically significant (p=0.0004). CONCLUSION HIV-RNA PCR (quantitative) is highly specific and sensitive test for diagnosing and excluding perinatal HIV infection in children in India.