ArticleJournal of clinical microbiology2012
Early diagnosis of in utero and intrapartum HIV infection in infants prior to 6 weeks of age.
Article in Journal of clinical microbiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 89 citations in OpenAlex.
- Reactivity of routine HIV antibody tests in children who initiated antiretroviral therapy in early infancy as part of the Children with HIV Early Antiretroviral Therapy (CHER) trial: a retrospective analysis.The Lancet. Infectious diseases · 2015Trial
- Timely and Efficient Infant Diagnosis Is Required to End AIDS in Children.Journal of the International AIDS Society · 2026Article
- Article
- Infant feeding knowledge, attitudes and practices of HIV-positive breastfeeding mothers.Health SA = SA Gesondheid · 2024Article
- Article
- The Cascade of Care From Routine Point-of-Care HIV Testing at Birth: Results From an 18-Months Pilot Program in Eswatini.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Uptake of care and treatment amongst a national cohort of HIV positive infants diagnosed at primary care level, South Africa.BMC infectious diseases · 2019Observational
- Correlates and determinants of Early Infant Diagnosis outcomes in North-Central Nigeria.AIDS research and therapy · 2019Article
- Evolving complexities of infant HIV diagnosis within Prevention of Mother-to-Child Transmission programs.F1000Research · 2019Review
- Infant HIV testing at birth using point-of-care and conventional HIV DNA PCR: an implementation feasibility pilot study in Kenya.Pilot and feasibility studies · 2019Article
- Investigation of prevention of mother to child HIV transmission program from 2011 to 2017 in Suzhou, China.Scientific reports · 2018Article
- Progress in the performance of HIV early infant diagnosis services in Zambia using routinely collected data from 2006 to 2016.BMC public health · 2018Article
- Performance of point-of-care birth HIV testing in primary health care clinics: An observational cohort study.PloS one · 2018Observational
- Strategies for screening cord blood for a public cord blood bank in high HIV prevalence regions.Global health, epidemiology and genomics · 2018Review
- Impact of Birth HIV-PCR Testing on the Uptake of Follow-up Early Infant Diagnosis Services in Cape Town, South Africa.The Pediatric infectious disease journal · 2017Article
- Time to first positive HIV-1 DNA PCR may differ with antiretroviral regimen in infants infected with non-B subtype HIV-1.AIDS (London, England) · 2017Article
- The value of confirmatory testing in early infant HIV diagnosis programmes in South Africa: A cost-effectiveness analysis.PLoS medicine · 2017Article
- Prevalence and outcomes of HIV-1 diagnostic challenges during universal birth testing - an urban South African observational cohort.Journal of the International AIDS Society · 2017Observational
- Improving early identification of HIV-infected neonates with birth PCR testing in a large urban hospital in Johannesburg, South Africa: successes and challenges.Journal of the International AIDS Society · 2017Article
- Article
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
Early initiation of antiretroviral therapy reduces HIV-related infant mortality. The early peak of pediatric HIV-related deaths in South Africa occurs at 3 months of age, coinciding with the earliest age at which treatment is initiated following PCR testing at 6 weeks of age. Earlier diagnosis is necessary to reduce infant mortality. The performances of the Amplicor DNA PCR, COBAS AmpliPrep/COBAS TaqMan (CAP/CTM), and Aptima assays for detecting early HIV infection (acquired in utero and intrapartum) up to 6 weeks of age were compared. Dried blood spots (DBS) were collected at birth and at 2, 4, and 6 weeks from HIV-exposed infants enrolled in an observational cohort study in Johannesburg, South Africa. HIV status was determined at 6 weeks by DNA PCR on whole blood. Serial DBS samples from all HIV-infected infants and two HIV-uninfected, age-matched controls were tested with the 3 assays. Of 710 infants of known HIV status, 38 (5.4%) had in utero (n = 29) or intrapartum (n = 9) infections. By 14 weeks, when treatment should have been initiated, 13 (45%) in utero-infected and 2 (22%) intrapartum-infected infants had died or were lost to follow-up. The CAP/CTM and Aptima assays identified 76.3% of all infants with early HIV infections at birth and by 4 weeks were 96% sensitive. DNA PCR demonstrated lower sensitivities at birth and 4 weeks of 68.4% and 87.5%, respectively. All assays had the lowest sensitivity at 2 weeks of age. CAP/CTM was the only assay with 100% specificity at all ages. Testing at birth versus 6 weeks of age identifies a higher total number of HIV-infected infants, irrespective of the assay.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.