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Journal of Tropical Pediatrics Advance Access published online on June 11, 2007
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmm032
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© The Author [2007]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

A Reverse Transcriptase Assay for Early Diagnosis of Infant HIV Infection in Resource-limited Settings

Sumathi Sivapalasingama, Usha Patelb, Vincenza Itria, Maura Lavertya, Kishorchandra Mandaliyab, Fred Valentinea and Shaffiq Essajeeb,c

aCenter for AIDS Research, Department of Medicine, Division of Infectious Diseases, New York University School of Medicine New York, NY
bAIDS Research and Family Care Clinic, Coast Province General Hospital, Mombasa, Kenya
cDepartment of Pediatrics, Division of Infectious Diseases, New York University School of Medicine, New York, NY

Correspondence: Sumathi Sivapalasingam, MD, New York University School of Medicine, 550 First Avenue, C&D Building, Rm 558, New York, NY 10016. E-mail < sumathi.sivapalasingam{at}gmail.com>.


  Abstract

Early diagnosis of pediatric HIV infection is confounded by persistence of maternal antibodies until 18 months, necessitating the use of expensive assays such as HIV-1 DNA PCR, an untenable option in resource-limited settings. This is the first report of a low-cost, commercial, reverse transcriptase (RT) assay for the diagnosis of HIV-1 infection in infants. RT assays were performed on 42 samples from 30 HIV-exposed Kenyan infants under 15 months of age. When correlated with serologic testing conducted after 18 months, the sensitivity, specificity, positive and negative predictive values of the RT assay were 92%, 93%, 87% and 96%. A low-cost assay for infant HIV diagnosis is urgently needed, and these results merit further evaluation.

Key Words: HIV • reverse transcriptase • diagnosis • infant • Africa.


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