Evidence map›Paper›PMID 27798549›Full record

ArticleThe Pediatric infectious disease journal2017

Performance of HIV Rapid Tests Among Breastfeeding, Malawian Infants.

Emily R Smith, Anna D Sheahan, Robert S Heyderman, William C Miller, Stephanie Wheeler, Michael Hudgens, Julie A E Nelson, Queen Dube, Annelies Van Rie

Open access · greenAbstract read
In one paragraph

Article in The Pediatric infectious disease journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 89% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 5 countries.

Emily R SmithFrom the *Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; †MLW Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi; ‡Division of Infectious Diseases, Department of Medicine, §Department of Health Policy and Management, Gillings Schools of Global Public Health, ¶Department of Biostatistics, Gillings School of Global Public Health, and ‖Department of Microbiology and Immunology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; **Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, Blantyre, Malawi; and ††Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium.
Anna D Sheahan
Robert S Heyderman
William C Miller
Stephanie Wheeler
Michael Hudgens
Julie A E Nelson
Queen Dube
Annelies Van Rie
Apple (Israel) · ILQueen Elizabeth Central Hospital · MWUniversity of Liverpool · GBUniversity of North Carolina at Chapel Hill · US

Funding

Virology, Immunology, and Microbiology CoreP30AI050410 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DAVID M. MARGOLIS · 2001 to 2026
$76.9M
Pediatric HIV-encephalopathy in DRC: effect of ART & role of compartmentalizationR01HD053216 · NICHD · UNIV OF NORTH CAROLINA CHAPEL HILL · PI VAN RIE, ANNELIES T.A. · 2006 to 2010
$2.0M
NIAID NIH HHS P30 AI050410NICHD NIH HHS R01 HD053216Wellcome Trust
6 · The paper itself

Abstract

introductionTimely, accurate and affordable testing algorithms at point-of-care are critical for early infant HIV diagnosis and initiation of antiretroviral therapy in the postpartum period. We aimed to assess the utility of HIV rapid tests for young, breast-fed HIV-exposed infants in resource limited, high HIV burden settings. MATERIALS AND

methodsWe collected data on the performance of 2 commonly used rapid tests (Determine and Unigold) in Malawi between 2008 and 2012 or at the University of North Carolina between 2014 and 2015. For each 3-month interval between ages 3 and 18 months, we calculated the sensitivity, specificity, positive and negative predictive values of each test compared with the HIV DNA/RNA PCR gold standard. We also assessed the utility of each rapid test to diagnose incident HIV infection during the breastfeeding period.

resultsAmong 121 HIV-exposed infants who were negative at age 6 weeks, 21 (17.2%) became infected by 18 months. At 3 months of age, both rapid tests had minimal clinical value with specificity values of 7.0% [95% confidence interval (CI): 2.3-15.7] for Determine and 19.4% (95% CI: 11.1-30.5) for Unigold. Starting at age 6 and 9 months, the Unigold test could be used as a screening tool in the follow-up of HIV-exposed infants with specificity values of 83.7% (95% CI: 74.4-89.9) and 97.7% (95% CI: 94.6-99.7), respectively. Starting at age 12 months, the type of test became less important as both tests performed well in identifying HIV-free children, although both tests failed to detect some incident HIV infections.

conclusionsUpdated guidelines for the use of rapid tests in young HIV-exposed children that explicitly take type of test and infant age into account are urgently needed to ensure optimal care for the 1.5 million HIV-exposed infants born annually.

Indexed as

Breast FeedingDNA, ViralEarly DiagnosisFemaleHIV-1HIV InfectionsHumansInfantInfectious Disease Transmission, VerticalPolymerase Chain ReactionProspective StudiesSensitivity and SpecificityVirologyDNA, Viral

Identifiers

PMID27798549
PMCPMC12834689
OpenAlexW2545696994

What OpenQuestion holds

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Registered trials

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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.