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Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots
BACKGROUND: Early diagnosis and treatment reduces HIV-1-related mortality, morbidity and size of viral reservoirs in infants infected perinatally. Commercial molecular tests enable the early diagnosis of infection in infants but the high cost and low sensitivity with dried blood spots (DBS) limit th...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513534/ https://www.ncbi.nlm.nih.gov/pubmed/28715460 http://dx.doi.org/10.1371/journal.pone.0181352 |
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author | Martin, Francisco Palladino, Claudia Mateus, Rita Bolzan, Anna Gomes, Perpétua Brito, José Carvalho, Ana Patrícia Cardoso, Yolanda Domingos, Cristovão Lôa Clemente, Vanda Sofia Taveira, Nuno |
author_facet | Martin, Francisco Palladino, Claudia Mateus, Rita Bolzan, Anna Gomes, Perpétua Brito, José Carvalho, Ana Patrícia Cardoso, Yolanda Domingos, Cristovão Lôa Clemente, Vanda Sofia Taveira, Nuno |
author_sort | Martin, Francisco |
collection | PubMed |
description | BACKGROUND: Early diagnosis and treatment reduces HIV-1-related mortality, morbidity and size of viral reservoirs in infants infected perinatally. Commercial molecular tests enable the early diagnosis of infection in infants but the high cost and low sensitivity with dried blood spots (DBS) limit their use in sub-Saharan Africa. OBJECTIVES: To develop and validate a sensitive and cheap qualitative proviral DNA PCR-based assay for early infant diagnosis (EID) in HIV-1-exposed infants using DBS samples. STUDY DESIGN: Chelex-based method was used to extract DNA from DBS samples followed by a nested PCR assay using primers for the HIV-1 integrase gene. Limit of detection (LoD) was determined by Probit regression using limiting dilutions of newly produced recombinant plasmids with the integrase gene of all HIV-1 subtypes and ACH-2 cells. Clinical sensitivity and specificity were evaluated on 100 HIV-1 infected adults; 5 infected infants; 50 healthy volunteers; 139 HIV-1-exposed infants of the Angolan Pediatric HIV Cohort (APEHC) with serology at 18 months of life. RESULTS: All subtypes and CRF02_AG were amplified with a LoD of 14 copies. HIV-1 infection in infants was detected at month 1 of life. Sensitivity rate in adults varied with viral load, while diagnostic specificity was 100%. The percentage of HIV-1 MTCT cases between January 2012 and October 2014 was 2.2%. The cost per test was 8-10 USD which is 2- to 4-fold lower in comparison to commercial assays. CONCLUSIONS: The new PCR assay enables early and accurate EID. The simplicity and low-cost of the assay make it suitable for generalized implementation in Angola and other resource-constrained countries. |
format | Online Article Text |
id | pubmed-5513534 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-55135342017-08-07 Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots Martin, Francisco Palladino, Claudia Mateus, Rita Bolzan, Anna Gomes, Perpétua Brito, José Carvalho, Ana Patrícia Cardoso, Yolanda Domingos, Cristovão Lôa Clemente, Vanda Sofia Taveira, Nuno PLoS One Research Article BACKGROUND: Early diagnosis and treatment reduces HIV-1-related mortality, morbidity and size of viral reservoirs in infants infected perinatally. Commercial molecular tests enable the early diagnosis of infection in infants but the high cost and low sensitivity with dried blood spots (DBS) limit their use in sub-Saharan Africa. OBJECTIVES: To develop and validate a sensitive and cheap qualitative proviral DNA PCR-based assay for early infant diagnosis (EID) in HIV-1-exposed infants using DBS samples. STUDY DESIGN: Chelex-based method was used to extract DNA from DBS samples followed by a nested PCR assay using primers for the HIV-1 integrase gene. Limit of detection (LoD) was determined by Probit regression using limiting dilutions of newly produced recombinant plasmids with the integrase gene of all HIV-1 subtypes and ACH-2 cells. Clinical sensitivity and specificity were evaluated on 100 HIV-1 infected adults; 5 infected infants; 50 healthy volunteers; 139 HIV-1-exposed infants of the Angolan Pediatric HIV Cohort (APEHC) with serology at 18 months of life. RESULTS: All subtypes and CRF02_AG were amplified with a LoD of 14 copies. HIV-1 infection in infants was detected at month 1 of life. Sensitivity rate in adults varied with viral load, while diagnostic specificity was 100%. The percentage of HIV-1 MTCT cases between January 2012 and October 2014 was 2.2%. The cost per test was 8-10 USD which is 2- to 4-fold lower in comparison to commercial assays. CONCLUSIONS: The new PCR assay enables early and accurate EID. The simplicity and low-cost of the assay make it suitable for generalized implementation in Angola and other resource-constrained countries. Public Library of Science 2017-07-17 /pmc/articles/PMC5513534/ /pubmed/28715460 http://dx.doi.org/10.1371/journal.pone.0181352 Text en © 2017 Martin et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Martin, Francisco Palladino, Claudia Mateus, Rita Bolzan, Anna Gomes, Perpétua Brito, José Carvalho, Ana Patrícia Cardoso, Yolanda Domingos, Cristovão Lôa Clemente, Vanda Sofia Taveira, Nuno Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots |
title | Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots |
title_full | Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots |
title_fullStr | Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots |
title_full_unstemmed | Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots |
title_short | Early infant diagnosis of HIV-1 infection in Luanda, Angola, using a new DNA PCR assay and dried blood spots |
title_sort | early infant diagnosis of hiv-1 infection in luanda, angola, using a new dna pcr assay and dried blood spots |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513534/ https://www.ncbi.nlm.nih.gov/pubmed/28715460 http://dx.doi.org/10.1371/journal.pone.0181352 |
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