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Early HIV-1 diagnosis using in-house real-time PCR amplification on dried blood spots for infants in remote and resource-limited settings

Ngo-Giang-Huong, Nicole Pharm
Khamduang, Wootichai
Leurent, Baptiste
Collins, Intira
Nantasen, Issaren
Leechanachai, Pranee
Sirirungsi, Wasna
Limtrakul, Aram
Leusaree, Tasana
Comeau, Anne Marie
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Abstract

BACKGROUND: In resource-limited settings, most perinatally HIV-1-infected infants do not receive timely antiretroviral therapy because early HIV-1 diagnosis is not available or affordable.

OBJECTIVE: To assess the performance of a low-cost in-house real-time polymerase chain reaction (PCR) assay to detect HIV-1 DNA in infant dried blood spots (DBS).

METHODS: One thousand three hundred nineteen DBS collected throughout Thailand from non-breast-fed infants born to HIV-1-infected mothers were shipped at room temperature to a central laboratory.In-house real-time DNA PCR results were compared with Roche Amplicor HIV-1 DNA test (Version 1.5) results. In addition, we verified the Roche test performance on DBS sampled from 1218 other infants using as reference HIV serology result at 18 months of age.

RESULTS: Real-time DNA PCR and Roche DNA PCR results were 100% concordant. Compared with HIV serology results, the Roche test sensitivity was 98.6% (95% confidence interval: 92.6% to 100.0%) and its specificity at 4 months of age was 99.7% (95% confidence interval: 99.2% to 99.9%).

CONCLUSIONS: In-house real-time PCR performed as well as the Roche test in detecting HIV-1 DNA on DBS in Thailand. Combined use of DBS and real-time PCR assays is a reliable and affordable tool to expand access to early HIV-1 diagnosis in remote and resource-limited settings, enabling timely treatment for HIV-1-infected infants.

Source

J Acquir Immune Defic Syndr. 2008 Dec 15;49(5):465-71. Link to article on publisher's site

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DOI
10.1097/QAI.0b013e31818e2531
PubMed ID
18989220
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