Early diagnosis of perinatally acquired HIV infection by the polymerase chain reaction.

31 children born to HIV-seropositive mothers were tested for the presence of HIV infection by an HIV-polymerase chain reaction (PCR) assay within the first months of life, at a time when the antibody (AB) tests did not yet allow a diagnosis. The follow-up by Western Blot and/or antigen (Ag)-ELISA indicated an HIV infection in 10 of these children. Failure to detect HIV infection by prior PCR occurred in only 1 of these patients. In this case only one sample was obtained within the first week of life and the negative PCR result may have been due to an infection of the child at delivery rather than during pregnancy. No HIV infection was detected in the remaining 21 cases, using both PCR as well as conventional methods. The simultaneously performed Ag-ELISA was clearly inferior to PCR, identifying only 4 of the 9 PCR-positive patients as early as the PCR. The perinatal HIV transmission rate in Austria was shown to be 32%, similar to that described for other European countries.