Retention in care of infants diagnosed with HIV at birth: Beyond the diagnostic strategy
Southern African Journal of Infectious Diseases
| Field | Value | |
| Title | Retention in care of infants diagnosed with HIV at birth: Beyond the diagnostic strategy | |
| Creator | Christie, Michael J. du Plessis, Nicolette M. | |
| Description | Background: Birth HIV point-of-care (POC) tests curtail analytical testing issues and expedite diagnosis, potentially allowing for earlier mother-infant pair engagement and improved outcomes. Many children are lost post antiretroviral therapy (ART) initiation within the first 6 months of follow-up.Objectives: We compared 6-month retention in care, HIV viral load (VL) suppression and mortality among infants diagnosed with HIV at birth, using laboratory-based versus POC HIV PCR testing.Method: From 2018 to 2019, infants exposed to HIV underwent birth HIV PCR POC testing at Kalafong Provincial Tertiary Hospital in Tshwane District. Their outcomes were compared to a historical control born between 2014 and 2016, who exclusively underwent laboratory-based HIV PCR testing. Both groups received comparable HIV care following national guidelines.Results: Fifty-seven infants were studied (POC: 27; Control: 30). The POC turnaround time was significantly shorter (POC: 15.5 h [IQR: 4.3–24.7], Control: 68.3 h [IQR 46.0–93.9]; p = 0.0001). Both populations had the same elapsed time from HIV diagnosis to ART initiation (median: 13 days, POC: IQR 8–21 days; Control: IQR 9–36 days). Six infants were never initiated (POC: 2 [7%]; Control: 4 [13%]). At 6 months, overall care retention was 72% (41/57), higher among the Control group (Control 23/30, 77%; POC: 18/27, 67%). HIV viral suppression at 6 months was higher among the POC group (POC: 14/18, 78%; Control: 9/19, 47%, p = 0.09). No deaths were reported.Conclusion: Poor care retention at 6 months post ART initiation is concerning. Initial mother-infant visits should be effectively utilised to assess and manage potential risk factors for loss of follow-up.Contribution: This study highlights the ongoing need to find workable solutions to improve retention in care, thereby ensuring the benefits of expedited HIV diagnosis and ART initiation. | |
| Publisher | AOSIS Publishing | |
| Date | 2024-03-30 | |
| Identifier | 10.4102/sajid.v39i1.589 | |
| Source | Southern African Journal of Infectious Diseases; Vol 39, No 1 (2024); 7 pages 2313-1810 2312-0053 | |
| Language | eng | |
| Relation |
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https://sajid.co.za/index.php/sajid/article/view/589/1437
https://sajid.co.za/index.php/sajid/article/view/589/1438
https://sajid.co.za/index.php/sajid/article/view/589/1439
https://sajid.co.za/index.php/sajid/article/view/589/1440
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