RESEARCH ARTICLE


RNA Detection and Subtype C Assessment of HIV-1 in Infants with Diarrhea in Ethiopia



Workenesh Ayele1, Tsehai Assefa1, Sileshi Lulseged2, Belete Tegbaru1, Hiwot Berhanu1, Wegene Tamene1, Zenit Ahmedin1, Birzaf W Tensai3, Mengistu Tafesse4, Jaap Goudsmit5, Ben Berkhout7, William A Paxton7, Michel P deBaar6, Tsehaynesh Messele1, Georgios Pollakis*, 7
1 Ethiopian Health and Nutrition Research Institute (EHNRI), Addis Ababa, Ethiopia
2 Department of Pediatrics at Faculty of Medicine, Addis Ababa University, Ethiopia
3 Department of Pediatrics at Yekatit 12 Hospital, Addis Ababa, Ethiopia
4 Department of Pediatrics at Armed Forces General Hospital, Addis Ababa, Ethiopia
5 Crucell Holland B.V., Leiden, The Netherlands
6 Primagen, Amsterdam, The Netherlands
7 Laboratory of Experimental Virology (LEV), Department of Medical Microbiology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Center of the University of Amsterdam, The Netherlands


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© Ayele et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Laboratory of Experimental Virology (LEV), University of Amsterdam, 1105 AZ Amsterdam, The Netherlands; Tel: 31-20-566-8572; Fax: 31-20-691-6531; E-mail: g.pollakis@amc.uva.nl


Abstract

In the absence of chemoprophylaxis, HIV-1 transmission occurs in 13-42% of infants born to HIV-1 positive mothers. All exposed infants acquire maternal HIV-1 antibodies that persist for up to 15 months, thereby hampering diagnosis. In resource limited settings, clinical symptoms are the indices of established infection against validated laboratorybased markers. Here we enrolled 1200 children hospitalized for diarrheal and other illnesses. 20-25% of those tested, aged 15 months or younger, were found to be HIV-1-seropositive. Where sufficient plasma was available, HIV-1 RNA detection was performed using a subtype-insensitive assay, with 71.1% of seropositive infants presenting with diarrhea showing positive. From sub-typing analysis, we identified that viruses of the C’ sub-cluster were predominated amongst infants. Although this study may overestimate the HIV-1 frequency through testing symptomatic infants, diarrhea can be seen as a useful marker indicating HIV-1 infection in infants less than 15 months old.

Keywords: Diagnosis, Diarrhea, Children, Seropositive, RNA, Ethiopia..