ArticleAIDS (London, England)2017
Infant/child rapid serology tests fail to reliably assess HIV exposure among sick hospitalized infants.
Article in AIDS (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02063880 (Urgent Versus Post-Stabilization ART in HIV-1 Infected Children With Severe Co-Infections), which is not on this map. Cited by 5 papers.
What it found
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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.
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.
Urgent Versus Post-Stabilization ART in HIV-1 Infected Children With Severe Co-Infections
Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Inpatient Point-of-Care HIV Early Infant Diagnosis in Mozambique to Improve Case Identification and Linkage to Antiretroviral Therapy.Global health, science and practice · 2021Article
- Pattern and Frequency of Seroreactivity to Routinely Used Serologic Tests in Early-Treated Infants With HIV.Journal of acquired immune deficiency syndromes (1999) · 2020Article
- Implementing an Indeterminate Range for More Accurate Early Infant Diagnosis.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Rapid Serological Tests Ineffectively Screen for HIV Exposure in HIV-Positive Infants.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Point-of-Care Early Infant Diagnosis Improves Adherence to the Testing Algorithm in Kenya.Journal of the International Association of Providers of AIDS CareObservational
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundThe WHO guidelines for infant and child HIV diagnosis recommend the use of maternal serology to determine child exposure status in ages 0-18 months, but suggest that infant serology can reliably be used to determine exposure for those less than 4 months. There is little evidence about the performance of these recommendations among hospitalized sick infants and children.
methodsWithin a clinical trial (NCT02063880) in Kenya, among children 18 months or younger, maternal and child rapid serologic HIV tests were performed in tandem. Dried blood spots were tested using HIV DNA PCR for all children whose mothers were seropositive, irrespective of child serostatus. We characterized the performance of infant/child serology results to detect HIV exposure in three age groups: 0-3, 4-8, and 9-18 months.
resultsAmong 65 maternal serology positive infants age 0-3 months, 48 (74%), 1 (2%) and 16 (25%) had positive, indeterminate and negative infant serology results, respectively. Twelve (25%), 0 and 4 (25%) of those with positive, indeterminate and negative infant serology results, respectively, were HIV-infected by DNA PCR. Among 71 maternal serology positive infants age 4-8 months, 31 (44%), 8 (11%) and 32 (45%) had positive, indeterminate and negative infant serology results, respectively. Fourteen (45%), 2 (25%) and 7 (22%) infants with positive, indeterminate and negative infant serology results, respectively, were HIV-infected. Among 67 maternal serology positive infants/children age 9-18 months, 40 (60%), 2 (3%) and 25 (37%) had positive, indeterminate and negative infant serology results, respectively. Thirty-six (90%), 2 (100%) and 2 (8%) infants with positive, indeterminate and negative infant serology results, respectively, were HIV-infected. In the 0-3, 4-8 and 9-18 month age groups, use of maternal serology to define HIV exposure identified 33% [95% confidence interval (CI) 10-65%], 44% (95% CI 20-70%) and 5% (95% CI 0.1-18%) more HIV infections, respectively.
conclusionMaternal serology should preferentially be used for screening among hospitalized infants of all ages to improve early diagnosis of children with HIV.
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