Observational studyJournal of the International AIDS Society2017
Prevalence and outcomes of HIV-1 diagnostic challenges during universal birth testing - an urban South African observational cohort.
Observational study in Journal of the International AIDS Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 23 citations in OpenAlex.
- Estimating the cost of diagnosing HIV at birth in Lesotho.PloS one · 2018Trial
- Cohort profile: Rahima Moosa Mother and Child Hospital maternal HIV cohort, Johannesburg, South Africa.BMJ open · 2024Article
- Optimization of the vertical transmission prevention program in Guinea: impact of the improvement plan on performance indicators at large-cohort sites.AIDS research and therapy · 2024Review
- Growth Trajectories Over the First Year of Life Among Early-Treated Infants with Human Immunodeficiency Virus and Infants Who are Human Immunodeficiency Virus-Exposed Uninfected.The Journal of pediatrics · 2024Article
- HIV diagnostic challenges in breast-fed infants of mothers on antiretroviral therapy.AIDS (London, England) · 2019Article
- Increasing Diagnostic Uncertainties in Children With In Utero HIV Infection.The Pediatric infectious disease journal · 2019Article
- Point-of-care HIV testing best practice for early infant diagnosis: an implementation study.BMC public health · 2019Article
- Early infant diagnosis HIV-1 PCR cycle-threshold predicts infant viral load at birth.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2019Article
- Evolving complexities of infant HIV diagnosis within Prevention of Mother-to-Child Transmission programs.F1000Research · 2019Review
- 12-month outcomes of HIV-infected infants identified at birth at one maternity site in Johannesburg, South Africa: an observational cohort study.The lancet. HIV · 2018Observational
- Achieving UNAIDS 90-90-90 targets for pregnant and postpartum women in sub-Saharan Africa: progress, gaps and research needs.Journal of virus eradication · 2018Article
- Neonatal and infant diagnostic HIV-PCR uptake and associations during three sequential policy periods in Cape Town, South Africa: a longitudinal analysis.Journal of the International AIDS Society · 2018Article
- Strategies for Identifying and Linking HIV-Infected Infants, Children, and Adolescents to HIV Treatment Services in Resource Limited Settings.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- A public health approach to addressing and preventing misdiagnosis in the scale-up of HIV rapid testing programmes.Journal of the International AIDS Society · 2017Article
Corrections and comments
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
Abstract
introductionHIV-1 polymerase chain reaction (PCR) testing at birth aims to facilitate earlier initiation of antiretroviral therapy (ART) for HIV-infected neonates. Data from two years of universal birth testing implementation in a high-burden South African urban setting are presented to demonstrate the prevalence and outcomes of diagnostic challenges in this context.
methodsHIV-exposed neonates born at Rahima Moosa Mother and Child Hospital between 5 June 2014 and 31 August 2016 were routinely screened at birth for HIV-1 on whole blood samples using the COBAS® AmpliPrep/COBAS® TaqMan (CAP/CTM) HIV-1 Qualitative Test, version 2.0 (Roche Molecular Systems, Inc., Branchburg, NJ, USA). Virological results were interpreted according to standard operating procedures with the South African National Health Laboratory Service. All neonates with non-negative results were actively followed-up and categorized according to HIV infection status as positive, negative, uncertain and lost to follow-up (LTFU).
results104 (1.8%) of 5743 HIV-exposed neonates received a non-negative birth PCR result, for which laboratory data were available for 102 (98%) cases - 78 (76%) tested positive and 24 (24%) indeterminate. HIV infection status was confirmed positive in 83 (81%) infants, negative in 8 (8%), uncertain in 5 (5%) and LTFU in 6 (6%) cases. The positive predictive value (excluding cases of uncertain diagnosis and inadequate testing) following a non-negative HIV-1 PCR screening test at birth was 0.91 (83/91; 95% confidence interval: 0.85-0.96). Neonates testing positive at birth had significantly higher viral load (VL) results than those testing indeterminate at birth of 4.5 and 3.0 log copies/ml (
conclusionIndeterminate HIV-1 PCR results accounted for a quarter of non-negative results at birth and were associated with a high risk of infection in comparison to the risk of
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