Journal Article

Early Diagnosis of HIV in Children below 18 months using DNA PCR Test—Assessment of the Effectiveness of PMTCT Interventions and Challenges in Early Initiation of ART in a Resource-Limited Setting

Anil Gupta, Girraj Singh, Pratap Kaushik, Bipin Joshi, Kamlesh Kalra and Sabyasachi Chakraborty

in Journal of Tropical Pediatrics

Volume 59, issue 2, pages 120-126
Published in print April 2013 | ISSN: 0142-6338
Published online December 2012 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fms063
Early Diagnosis of HIV in Children below 18 months using DNA PCR Test—Assessment of the Effectiveness of PMTCT Interventions and Challenges in Early Initiation of ART in a Resource-Limited Setting

Show Summary Details

Preview

This study was conducted to assess efficacy of the current Indian Prevention of Mother-to-Child Transmission (PMTCT) protocol in 217 HIV-exposed infants, and to assess challenges in the early initiation of antiretroviral treatment (ART) in 18 (8.3%) infants with HIV, as determined by the HIV-1 DNA polymerase chain reaction (PCR) test at ≥6 weeks to <18 months of age. The mother-to-child transmission (MTCT) rate in 154 mother–baby pairs fully compliant with the PMTCT protocol was 5.2%. However, if 25 pairs who were positive using dried blood spot (DBS) DNA PCR and who did not undergo whole blood testing are included in the analysis, then the overall MTCT rate would be 19.8%. The current protocol is 50% effective considering an MTCT rate of 35–40% without any intervention. ART was initiated in 10 (55.6%) HIV-infected children at a mean ± standard deviation (SD) age of 10.45 ± 4.9 (range: 4–17.5) months; delay resulted in opportunistic infections in one-third of the children. A single-dose nevirapine PMTCT regimen should be replaced by a triple antiretroviral regimen; DBS DNA PCR-positive infants may be given ART, and simultaneously a whole blood specimen should be taken to determine whether ART should be continued.

Journal Article.  3068 words.  Illustrated.

Subjects: Paediatrics

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.