American Journal of Obstetrics & Gynecology
Volume 197, Issue 3, Supplement , Pages S64-S71 , September 2007

Infant human immunodeficiency virus diagnosis in resource-limited settings: issues, technologies, and country experiences

  • Tracy L. Creek, MD

      Affiliations

    • Centers for Disease Control and Prevention/National Center for HIV, Hepatitis, STD, TB Prevention/Global AIDS Program, Atlanta, GA
    • Corresponding Author InformationReprints: Dr. Tracy L Creek, Centers for Disease Control and Prevention/National Center for HIV, Hepatitis, STD, TB Prevention/ Global AIDS Program/Prevention of Mother-to-Child Transmission Team, 1600 Clifton Rd, MS E-04, Atlanta, GA 30333.
    • ,
  • Gayle G. Sherman, MD, PhD

      Affiliations

    • University of the Witwatersrand and National Health Laboratory Service, Johannesburg Hospital, Johannesburg, South Africa
    • ,
  • John Nkengasong, PhD

      Affiliations

    • Centers for Disease Control and Prevention/National Center for HIV, Hepatitis, STD, TB Prevention/Global AIDS Program, Atlanta, GA
    • ,
  • Lydia Lu, MPH

      Affiliations

    • Centers for Disease Control and Prevention/National Center for HIV, Hepatitis, STD, TB Prevention/Global AIDS Program, Atlanta, GA
    • ,
  • Thomas Finkbeiner, MD, MPH

      Affiliations

    • Centers for Disease Control and Prevention/National Center for HIV, Hepatitis, STD, TB Prevention/Global AIDS Program, Dar es Salaam, Tanzania
    • ,
  • Mary Glenn Fowler, MD, MPH

      Affiliations

    • Makerere University–Johns Hopkins University Research Collaboration, Kampala, Uganda.
    • ,
  • Emilia Rivadeneira, MD

      Affiliations

    • Centers for Disease Control and Prevention/National Center for HIV, Hepatitis, STD, TB Prevention/Global AIDS Program, Atlanta, GA
    • ,
  • Nathan Shaffer, MD

      Affiliations

    • Centers for Disease Control and Prevention/National Center for HIV, Hepatitis, STD, TB Prevention/Global AIDS Program, Atlanta, GA

Received 15 December 2006 ,Revised 16 February 2007 ,Accepted 1 March 2007.

References 

  1. Nolan ML, Greenberg AE, Fowler MG. A review of clinical trials to prevent mother-to-child HIV-1 transmission in Africa and inform rational intervention strategies. AIDS. 2002;16:1991–1999
  2. Newell ML, Coovadia H, Cortina-Borja M, Rollins N, Gaillard P, Dabis F. Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis. Lancet. 2004;364:1236–1243
  3. Jackson JB, Musoke P, Fleming T, et al. Intrapartum and neonatal single-dose nevirapine compared with zidovudine for prevention of mother-to-child transmission of HIV-1 in Kampala, Uganda: 18-month follow-up of the HIVNET 012 randomised trial. Lancet. 2003;362:859–868
  4. Obimbo EM, Mbori-Ngacha DA, Ochieng JO, et al. Predictors of early mortality in a cohort of human immunodeficiency virus type 1-infected African children. Pediatr Infect Dis J. 2004;23:536–543
  5. Jones SA, Sherman GG, Coovadia AH. Can clinical algorithms deliver an accurate diagnosis of HIV infection in infancy?. Bull World Health Organ. 2005;83:559–560
  6. Parekh BS, Shaffer N, Coughlin R, et al. Human immunodeficiency virus 1-specific IgA capture enzyme immunoassay for early diagnosis of human immunodeficiency virus 1 infection in infants (NYC Perinatal HIV Transmission Study Group). Pediatr Infect Dis J. 1993;12:908–913
  7. Palasanthiran P, Robertson P, Ziegler JB, Graham GG. Decay of transplacental human immunodeficiency virus type 1 antibodies in neonates and infants. J Infect Dis. 1994;170:1593–1596
  8. Moodley D, Bobat RA, Coutsoudis A, Coovadia HM. Predicting perinatal human immunodeficiency virus infection by antibody patterns. Pediatr Infect Dis J. 1995;14:850–852
  9. Brambilla D, Jennings C, Aldrovandi G, et al. Multicenter evaluation of use of dried blood and plasma spot specimens in quantitative assays for human immunodeficiency virus RNA: measurement, precision, and RNA stability. J Clin Microbiol. 2003;41:1888–1893
  10. Varga CA, Sherman GG, Maphosa J, Jones SA. Psychosocial consequences of early diagnosis of HIV status in vertically exposed infants in Johannesburg, South Africa. Health Care Women Int. 2005;26:387–397
  11. Berk DR, Falkovitz-Halpern MS, Hill DW, et al. Temporal trends in early clinical manifestations of perinatal HIV infection in a population-based cohort. JAMA. 2005;293:2221–2231
  12. Gichuhi C, Obimbo E, Mbori-Ngacha D, et al. Predictors of mortality in HIV-1 exposed uninfected post-neonatal infants at the Kenyatta National Hospital, Nairobi. East Afr Med J. 2005;82:447–451
  13. Stringer JS, Sinkala M, Maclean CC, et al. Effectiveness of a city-wide program to prevent mother-to-child HIV transmission in Lusaka, Zambia. AIDS. 2005;19:1309–1315
  14. United Children’s FundWorld Health Organization. UNICEF/WHO technical consultation: improving access to appropriate paediatric ARV formulations. Geneva (Switzerland): World Health Organization; 2004;
  15. World Health Organization. Antiretroviral therapy of HIV infection in infants and children in resource-limited settings: towards universal access. Geneva (Switzerland): World Health Organization; 2006;
  16. Kankasa C, Katepa-Bwalya M, Bulterys M, et al. Routine and universal counseling and testing among hospitalized children at a University Teaching Hospital, Lusaka, Zambia. In: Presented at the 2006 HIV/AIDS Implementers’ Meeting, Durban, South Africa.. 2006;
  17. Humphrey J, Marinda E, Moulton L, et al. Breastfeeding-associated HIV transmission among women who seroconvert during late pregnancy and during breastfeeding. In: Presented at the AIDS 2006—XVI International AIDS Conference, Toronto, Canada.. 2006;
  18. Otieno FA, Mbori-Ngacha DA, Wafula EM, Ndinya-Achola JO. Evaluation of a proposed clinical case definition of paediatric acquired immune deficiency syndrome. East Afr Med J. 2002;79:111–114
  19. Jones S, Sherman G. Death before diagnosis: IMCI clinical algorithm fails to identify HIV infected infants under the age of 12 months. In: Presented at the International Conference on AIDS, Bangkok, Thailand; July 11-16. 2004;
  20. Blackburn L, Sherman G, Coovadia A, Foromo R. HIV rapid tests can be used as a screening tool to reduce HIV DNA PCR assays in a resource-poor setting. In: Presented at the 2006 HIV/AIDS Implementers’ Meeting, Durban, South Africa.. 2006;
  21. Sherman GG, Jones SA. Oral fluid human immunodeficiency virus tests: improved access to diagnosis for infants in poorly resourced prevention of mother to child transmission programs. Pediatr Infect Dis J. 2005;24:253–256
  22. American Academy of Pediatrics. Red Book: 2006 Report of the Committee on Infectious Diseases. In:  Pickering L,  Baker C,  Long S,  McMillan J editor. Elk Grove Village (Illinois): American Academy of Pediatrics; 2006;
  23. Bremer JW, Lew JF, Cooper E, et al. Diagnosis of infection with human immunodeficiency virus type 1 by a DNA polymerase chain reaction assay among infants enrolled in the Women and Infants’ Transmission Study. J Pediatr. 1996;129:198–207
  24. Sherman GG, Cooper PA, Coovadia AH, et al. Polymerase chain reaction for diagnosis of human immunodeficiency virus infection in infancy in low resource settings. Pediatr Infect Dis J. 2005;24:993–997
  25. Sherman GG, Jones SA, Coovadia AH, Urban MF, Bolton KD. PMTCT from research to reality—results from a routine service. S Afr Med J. 2004;94:289–292
  26. Lyamuya E, Olausson-Hansson E, Albert J, Mhalu F, Biberfeld G. Evaluation of a prototype Amplicor PCR assay for detection of human immunodeficiency virus type 1 DNA in blood samples from Tanzanian adults infected with HIV-1 subtypes A, C and D. J Clin Virol. 2000;17:57–63
  27. Cassol S, Weniger BG, Babu PG, et al. Detection of HIV type 1 env subtypes A, B, C, and E in Asia using dried blood spots: a new surveillance tool for molecular epidemiology. AIDS Res Hum Retroviruses. 1996;12:1435–1441
  28. World Health Organization. Draft (Recommendations on the diagnosis of HIV infection in infants and children). Geneva (Switzerland): World Heath Organization; 2006;
  29. Cunningham CK, Charbonneau TT, Song K, et al. Comparison of human immunodeficiency virus 1 DNA polymerase chain reaction and qualitative and quantitative RNA polymerase chain reaction in human immunodeficiency virus 1-exposed infants. Pediatr Infect Dis J. 1999;18:30–35
  30. Zhao Y, Yu M, Miller JW, et al. Quantification of human immunodeficiency virus type 1 proviral DNA by using TaqMan technology. J Clin Microbiol. 2002;40:675–678
  31. Katsoulidou A, Petrodaskalaki M, Sypsa V, et al. Evaluation of the clinical sensitivity for the quantification of human immunodeficiency virus type 1 RNA in plasma: comparison of the new COBAS TaqMan HIV-1 with three current HIV-RNA assays—LCx HIV RNA quantitative, VERSANT HIV-1 RNA 3.0 (bDNA) and COBAS AMPLICOR HIV-1 Monitor v1.5. J Virol Methods. 2006;131:168–174
  32. Sherman GG, Stevens G, Stevens WS. Affordable diagnosis of human immunodeficiency virus infection in infants by p24 antigen detection. Pediatr Infect Dis J. 2004;23:173–176
  33. Patton JC, Sherman GG, Coovadia AH, Stevens WS, Meyers TM. Ultrasensitive human immunodeficiency virus type 1 p24 antigen assay modified for use on dried whole-blood spots as a reliable, affordable test for infant diagnosis. Clin Vaccine Immunol. 2006;13:152–155
  34. Benjamin DK, Miller WC, Fiscus SA, et al. Rational testing of the HIV-exposed infant. Pediatrics. 2001;108:E3
  35. Mrus JM, Yi MS, Eckman MH, Tsevat J. The impact of expected HIV transmission rates on the effectiveness and cost of ruling out HIV infection in infants. Med Decis Making. 2002;22:S38–S44
  36. Miotti PG, Taha TE, Kumwenda NI, et al. HIV transmission through breastfeeding: a study in Malawi. JAMA. 1999;282:744–749
  37. Iliff PJ, Piwoz EG, Tavengwa NV, et al. Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS. 2005;19:699–708
  38. Coutsoudis A, Dabis F, Fawzi W, et al. Late postnatal transmission of HIV-1 in breast-fed children: an individual patient data meta-analysis. J Infect Dis. 2004;189:2154–2166
  39. Ross JS, Labbok MH. Modeling the effects of different infant feeding strategies on infant survival and mother-to-child transmission of HIV. Am J Public Health. 2004;94:1174–1180
  40. Piwoz EG, Ross JS. Use of population-specific infant mortality rates to inform policy decisions regarding HIV and infant feeding. J Nutr. 2005;135:1113–1119
  41. Homsy J, Moore D, Barasa A, et al. Mother-to-child HIV transmission and infant mortality among women receiving highly active antiretroviral therapy (HAART) in rural Uganda. In: Presented at the AIDS 2006—XVI International AIDS Conference, Toronto, Canada.. 2006;
  42. World Health Organization. HIV and infant feeding: guidelines for decision-makers—a guide for health care managers and supervisors. In: World Health Organization, editors. Geneva (Switzerland): World Health Organization; 2003.
  43. Chintu C, Bhat GJ, Walker AS, et al. Co-trimoxazole as prophylaxis against opportunistic infections in HIV-infected Zambian children (CHAP): a double-blind, randomised, placebo-controlled trial. Lancet. 2004;364:1865–1871

 The findings and views expressed herein are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

PII: S0002-9378(07)00292-X

doi: 10.1016/j.ajog.2007.03.002

American Journal of Obstetrics & Gynecology
Volume 197, Issue 3, Supplement , Pages S64-S71 , September 2007

Article Tools

* Image Usage & Resolution