Concordance of Polymerase Chain Reaction with Human Immunodeficiency Virus Antibody Detection

To evaluate the correlation of detection of human immunodeficiency virus (HIV) by polymer-ase chain reaction (PCR) with detection of HIV antibody, 271 simultaneous serum and periph-eral blood mononuclear cell samples were examined from 242 persons whose activities placed them at increased risk for HIV infection: 142 from homosexual men, 86 from hemophilic men, and 43 from heterosexual partners of HIV-infected persons. peR was performed using the gag region primer pair SK38/39 and the env region primer pairs SK68/69 and C071172. Amplified HIV DNA was detected using specific oligomer probes. Of 63 mv antibody-positive samples, 58 (92%) had HIV DNA by PCR. Of 208 HIV antibody-negative samples, 7 (3.4%) had mv DNA by PCR. On follow-up, 4 ofof the latter persons were seropositive when next tested; 2 were well and antibody- and PeR-negative; 1 had died ofa stroke before retesting. Thus, PCR detects mv in most antibody-positive persons; detection is increased by use of multiple primer pairs. PeR-positive antibody-negative specimens may indicate HIV infection in which antibody has not yet developed or may be false-positive PCR results. When PCR is discordant with HIV anti-body, testing ofadditional specimens and clinical follow-up are necessary to assess HIV infection status