This case series reports three infants diagnosed with HIV-1 infection using DNA polymerase chain reaction (PCR) testing. The three children were initiated on antiretroviral therapy (ART) at ten, four and six months of age. Their serological tests at 18 months of age were negative for HIV-1. The first child was discontinued from ART. The other two children were HIV-negative after 18 months, but were continued on ART. Such seroreversion may be either due to viral suppression or false-positive DNA PCR results. There is a need to develop guidelines to address such discordant cases.
ViolariACottonMFGibbDM. for the CHER Study Team. Early antiretroviral therapy and mortality among HIV-infected infants. N Engl J Med2008; 359: 2233–2244.
2.
BourneDEThompsonMBrodyLL. Emergence of a peak in early infant mortality due to HIV/AIDS in South Africa. AIDS2009; 23: 101–106.
3.
NewellMLCoovadiaHCortina-BorjaM. the Ghent International AIDS Society (IAS) Working Group on HIV Infection in Women and Children. Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis. Lancet2004; 364: 1236–1243.
4.
MarindaEHumphreyJHIliffPJ. the ZVITAMBO Study Group. Child mortality according to maternal and infant HIV status in Zimbabwe. Pediatr Infect Dis J2007; 26: 519–526.
5.
WHO. WHO recommendations on the diagnosis of HIV infection in infants & children. Geneva: WHO, 2010.
Government of India, Ministry of Health and Family Welfare, Department of AIDS Control. Updated guidelines for prevention of parent-to-child transmission (PPTCT) of HIV using multi drug anti-retroviral regimen in India, December 2013. Available at: http://www.naco.gov.in/documents/policy-guidelines (accessed 14 September 2016).
8.
PersaudDGayHZiemniakC. Absence of detectable HIV-1 viremia after treatment cessation in an infant. N Engl J Med2013; 369: 1828–1835.
9.
LuzuriagaKGayHZiemniakC. Viremic relapse after HIV-1 remission in a perinatally infected child. N Engl J Med2015; 372: 786–788.
10.
MathaiSAdhikariKM. Repeated false positive HIV DNA PCR in an exposed infant. MJAFI2013; 69: 392–393.
11.
ShahI. Efficacy of HIV PCR techniques to diagnose HIV in infants born to HIV infected mothers – an Indian perspective. J Assoc Physicians India2006; 54: 197–199.
12.
AgarwalDAgrawalNR. False positive HIV-1 DNA PCR in infancy. Indian Pediatr2008; 45: 245–246.
13.
BaveewoSKamyaMRMayanja-KizzaH. Potential for false positive HIV test results with the serial rapid HIV testing algorithm. BMC Res Notes2012; 5: 154–157.
14.
Garcia-PratsAJDraperHRSandersJE. False-negative post-18-month confirmatory HIV tests in HIV DNA PCR-positive children: a retrospective analysis. AIDS2012; 26: 1927–1934.
