BACKGROUND: The prevalence of human immunodeficiency virus (HIV) infection is rising in Sub- Saharan Africa. The various indirect tests readily available have not been helpful in neonatal and early infant diagnosis of the disease. Polymerase chain reaction (PCR) is a direct test that can be used in these groups of children. Early infant diagnosis is important in achieving good outcome in the management of HIV infection. The aim of this article was to examine the role of PCR in the evaluation HIV-infected infants, with a view to achieve early diagnosis, early treatment, and good outcome. MATERIALS AND METHODS: This was a prospective review of 174 infants delivered by HIV-infected mothers in a rural hospital from January 2007 to September 2008. The blood samples of the patients were collected and subjected to PCR analysis for detection of viral antigen. Two samples were collected, the first at 6 weeks and the second 6 weeks after that. The results were recorded, collated, and analyzed using SPSS version 17. RESULTS: There were 174 infants, 100 boys, and 74 girls. The age range was 6-8 weeks (median 6 weeks). PCR was positive for both the samples in 12 (6.9%) infants. PCR was negative in both samples in 162 (93.1%) infants. All infants who were negative in the first sampling were found to be negative in the second sampling as well. None of the infant was positive for only one sample. Analysis of 12 positive infants revealed that 5 (2.9%) infants were placed on anti-retroviral drugs, 3 (1.7%) infants were not placed on anti-retroviral drugs because of low CD+ count, and 1 (1.0%) infant was lost to follow-up, while 3 (1.7%) infants died from sepsis. CONCLUSION: PCR has a role as a direct test in early diagnosis of HIV infection in infancy, particularly where the other direct test are not readily available.
BACKGROUND: The prevalence of human immunodeficiency virus (HIV) infection is rising in Sub- Saharan Africa. The various indirect tests readily available have not been helpful in neonatal and early infant diagnosis of the disease. Polymerase chain reaction (PCR) is a direct test that can be used in these groups of children. Early infant diagnosis is important in achieving good outcome in the management of HIV infection. The aim of this article was to examine the role of PCR in the evaluation HIV-infectedinfants, with a view to achieve early diagnosis, early treatment, and good outcome. MATERIALS AND METHODS: This was a prospective review of 174 infants delivered by HIV-infected mothers in a rural hospital from January 2007 to September 2008. The blood samples of the patients were collected and subjected to PCR analysis for detection of viral antigen. Two samples were collected, the first at 6 weeks and the second 6 weeks after that. The results were recorded, collated, and analyzed using SPSS version 17. RESULTS: There were 174 infants, 100 boys, and 74 girls. The age range was 6-8 weeks (median 6 weeks). PCR was positive for both the samples in 12 (6.9%) infants. PCR was negative in both samples in 162 (93.1%) infants. All infants who were negative in the first sampling were found to be negative in the second sampling as well. None of the infant was positive for only one sample. Analysis of 12 positive infants revealed that 5 (2.9%) infants were placed on anti-retroviral drugs, 3 (1.7%) infants were not placed on anti-retroviral drugs because of low CD+ count, and 1 (1.0%) infant was lost to follow-up, while 3 (1.7%) infants died from sepsis. CONCLUSION: PCR has a role as a direct test in early diagnosis of HIV infection in infancy, particularly where the other direct test are not readily available.