Viral load assay performs comparably to early infant diagnosis assay to diagnose infants with HIV in Mozambique: a prospective observational study.

Abstract:

INTRODUCTION:Viral load testing is essential to manage HIV disease, especially in infants and children. Early infant diagnosis is performed using nucleic-acid testing in children under 18 months. Resource-limited health systems face severe challenges to scale-up both viral load and early infant diagnosis to unprecedented levels. Streamlining laboratory systems would be beneficial to improve access to quality testing and to increase efficiency of antiretroviral treatment programmes. We evaluated the performance of viral load testing to serve as an early infant diagnosis assay in children younger than 18 months. METHODS:This study was an observational, prospective study, including children between one and 18 months of age who were born to HIV-positive mothers in 134 health facilities in Maputo City and Maputo Province, Mozambique. Dried blood spot specimens from heel or toe pricks were collected between January and April 2018, processed using SPEX buffer for both assays, and tested for routine EID and VL testing using the Roche CAP/CTM HIV-1 Qualitative v2 and Roche CAP/CTM HIV-1 Quantitative v2 assays respectively. The sensitivity, specificity and positive and negative predictive values were estimated using the EID results as the reference standard. RESULTS:A total of 1021 infants were included in the study, of which 47% were female. Over 95% of mothers and children were on antiretroviral treatment or received antiretroviral prophylaxis respectively. The sensitivity and specificity of using the viral load assay to detect infection were 100% (95% CI: 96.2 to 100%) and 99.9% (95% CI: 99.4 to 100%). The positive and negative predictive values were 99.0% (95% CI: 94.3 to 100%) and 100% (95% CI: 99.6 to 100%). The McNemar's test was 1.000 and Cohen's kappa was 0.994. CONCLUSIONS:The comparable performance suggests that viral load assays can be used as an infant diagnostic assay. Infants with either low levels of viraemia or high cycle threshold values should be repeat tested to ensure the result is truly positive prior to treatment initiation, regardless of assay used. Viral load assays could replace traditional early infant diagnosis testing, substantially streamlining molecular laboratory services for children and lowering costs, with the additional advantage of providing baseline viral load results for antiretroviral treatment management.

journal_name

J Int AIDS Soc

authors

Vubil A,Nhachigule C,Loquiha O,Meggi B,Mabunda N,Bollinger T,Sacks JA,Jani I,Vojnov L

doi

10.1002/jia2.25422

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

e25422

issue

1

issn

1758-2652

journal_volume

23

pub_type

杂志文章
  • Retention on antiretroviral therapy during Universal Test and Treat implementation in Zomba district, Malawi: a retrospective cohort study.

    abstract:INTRODUCTION:Since June 2016, the national HIV programme in Malawi has adopted Universal Test and Treat (UTT) guidelines requiring that all persons who test HIV positive will be referred to start antiretroviral therapy (ART). Although there is strong evidence from clinical trials that early initiation of ART leads to r...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1002/jia2.25239

    authors: Alhaj M,Amberbir A,Singogo E,Banda V,van Lettow M,Matengeni A,Kawalazira G,Theu J,Jagriti MR,Chan AK,van Oosterhout JJ

    更新日期:2019-02-01 00:00:00

  • The HIV drug optimization agenda: promoting standards for earlier investigation and approvals of antiretroviral drugs for use in adolescents living with HIV.

    abstract:INTRODUCTION:Most clinical trials for new antiretroviral (ARV) agents are conducted among narrowly defined adult populations. Only after safety and efficacy have been clearly demonstrated among adults living with HIV are trials including adolescents, children and infants conducted. This approach contributes to signific...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1002/jia2.25576

    authors: Rojo P,Carpenter D,Venter F,Turkova A,Penazzato M

    更新日期:2020-09-01 00:00:00

  • Pharmacokinetics-based adherence measures for antiretroviral therapy in HIV-infected Kenyan children.

    abstract:BACKGROUND:Traditional medication adherence measures do not account for the pharmacokinetic (PK) properties of the drugs, potentially misrepresenting true therapeutic exposure. METHODS:In a population of HIV-infected Kenyan children on antiretroviral therapy including nevirapine (NVP), we used a one-compartment model ...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.20.1.21157

    authors: Tu W,Nyandiko WM,Liu H,Slaven JE,Scanlon ML,Ayaya SO,Vreeman RC

    更新日期:2017-06-15 00:00:00

  • "Is it making any difference?" A qualitative study examining the treatment-taking experiences of asymptomatic people living with HIV in the context of Treat-all in Eswatini.

    abstract:INTRODUCTION:Treat-all is being implemented in several African settings, in accordance with 2015 World Health Organisation guidelines. The factors known to undermine adherence to antiretroviral therapy (ART) may change in the context of Treat-all, where people living with HIV (PLHIV) increasingly initiate ART at earlie...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1002/jia2.25220

    authors: Horter S,Wringe A,Thabede Z,Dlamini V,Kerschberger B,Pasipamire M,Lukhele N,Rusch B,Seeley J

    更新日期:2019-01-01 00:00:00

  • Tuberculosis: opportunities and challenges for the 90-90-90 targets in HIV-infected children.

    abstract:INTRODUCTION:In 2014 the Joint United Nations Programme on HIV/AIDS defined the ambitious 90-90-90 targets for 2020, in which 90% of people living with HIV must be diagnosed, 90% of those diagnosed should be on sustained therapy and 90% of those on therapy should have an undetectable viral load. Children are considered...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章,评审

    doi:10.7448/IAS.18.7.20236

    authors: Rabie H,Frigati L,Hesseling AC,Garcia-Prats AJ

    更新日期:2015-12-02 00:00:00

  • HIV among men who have sex with men in Malawi: elucidating HIV prevalence and correlates of infection to inform HIV prevention.

    abstract:INTRODUCTION:There are limited data characterizing the burden of HIV among men who have sex with men (MSM) in Malawi. Epidemiologic research and access to HIV prevention, treatment and care services have been traditionally limited in Malawi by criminalization and stigmatization of same-sex practices. To inform the deve...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.16.4.18742

    authors: Wirtz AL,Jumbe V,Trapence G,Kamba D,Umar E,Ketende S,Berry M,Strömdahl S,Beyrer C,Baral SD

    更新日期:2013-12-02 00:00:00

  • Placental Hofbauer cells assemble and sequester HIV-1 in tetraspanin-positive compartments that are accessible to broadly neutralizing antibodies.

    abstract:INTRODUCTION:Within monocyte-derived macrophages, HIV-1 accumulates in intracellular virus-containing compartments (VCCs) that are inaccessible to the external environment, which implicate these cells as latently infected HIV-1 reservoirs. During mother-to-child transmission of HIV-1, human placental macrophages (Hofba...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.18.1.19385

    authors: Johnson EL,Chu H,Byrareddy SN,Spearman P,Chakraborty R

    更新日期:2015-01-22 00:00:00

  • Drug use, HIV, HCV and TB: major interlinked challenges in Eastern Europe and Central Asia.

    abstract::Eastern Europe and Central Asia have the largest drug epidemic globally and the fastest and still expanding HIV epidemic. The Russian Federation and Ukraine together account for over 90% of the reported AIDS cases in the region. If small in absolute numbers, the epidemics are however significant in prevalence rate in ...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.17.4.19501

    authors: Kazatchkine M

    更新日期:2014-11-02 00:00:00

  • The role of family planning in achieving safe pregnancy for serodiscordant couples: commentary from the United States government's interagency task force on family planning and HIV service integration.

    abstract:INTRODUCTION:People living with HIV (PLHIV) have the right to exercise voluntary choices about their health, including their reproductive health. This commentary discusses the integral role that family planning (FP) plays in helping PLHIV, including those in serodiscordant relationships, achieve conception safely. The ...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章,评审

    doi:10.7448/IAS.20.2.21312

    authors: Mason J,Medley A,Yeiser S,Nightingale VR,Mani N,Sripipatana T,Abutu A,Johnston B,Watts DH

    更新日期:2017-03-08 00:00:00

  • Virological response and resistances over 12 months among HIV-infected children less than two years receiving first-line lopinavir/ritonavir-based antiretroviral therapy in Cote d'Ivoire and Burkina Faso: the MONOD ANRS 12206 cohort.

    abstract:INTRODUCTION:Lopinavir/ritonavir-based antiretroviral therapy (ART) is recommended for all HIV-infected children less than three years. However, little is known about its field implementation and effectiveness in West Africa. We assessed the 12-month response to lopinavir/ritonavir-based antiretroviral therapy in a coh...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.20.01.21362

    authors: Amani-Bosse C,Dahourou DL,Malateste K,Amorissani-Folquet M,Coulibaly M,Dattez S,Emieme A,Barry M,Rouzioux C,N'gbeche S,Yonaba C,Timité-Konan M,Mea V,Ouédraogo S,Blanche S,Meda N,Seguin-Devaux C,Leroy V

    更新日期:2017-04-25 00:00:00

  • Transactional sex and risk for HIV infection in sub-Saharan Africa: a systematic review and meta-analysis.

    abstract:INTRODUCTION:Young women aged 15 to 24 years in sub-Saharan Africa continue to be disproportionately affected by HIV. A growing number of studies have suggested that the practice of transactional sex may in part explain women's heightened risk, but evidence on the association between transactional sex and HIV has not y...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章,meta分析,评审

    doi:10.7448/IAS.19.1.20992

    authors: Wamoyi J,Stobeanau K,Bobrova N,Abramsky T,Watts C

    更新日期:2016-11-02 00:00:00

  • Adjusting HIV prevalence estimates for non-participation: an application to demographic surveillance.

    abstract:INTRODUCTION:HIV testing is a cornerstone of efforts to combat the HIV epidemic, and testing conducted as part of surveillance provides invaluable data on the spread of infection and the effectiveness of campaigns to reduce the transmission of HIV. However, participation in HIV testing can be low, and if respondents sy...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.18.1.19954

    authors: McGovern ME,Marra G,Radice R,Canning D,Newell ML,Bärnighausen T

    更新日期:2015-11-26 00:00:00

  • Online interventions to address HIV and other sexually transmitted and blood-borne infections among young gay, bisexual and other men who have sex with men: a systematic review.

    abstract:INTRODUCTION:Globally, young gay, bisexual and other men who have sex with men (gbMSM) continue to experience disproportionately high rates of HIV and other sexually transmitted and blood-borne infections (STBBIs). As such, there are strong public health imperatives to evaluate innovative prevention, treatment and care...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章,评审

    doi:10.1002/jia2.25017

    authors: Knight R,Karamouzian M,Salway T,Gilbert M,Shoveller J

    更新日期:2017-11-01 00:00:00

  • Dynamics in HIV-DNA levels over time in HIV controllers.

    abstract:INTRODUCTION:HIV controllers (HIC) maintain viraemia at low levels without antiretroviral treatment and have small HIV reservoirs. Nevertheless, they are heterogeneous regarding their risk of infection progression. The study of reservoirs can help elucidate this control. This study aimed to explore the factors implicat...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章,多中心研究

    doi:10.1002/jia2.25221

    authors: Avettand-Fenoel V,Bayan T,Gardiennet E,Boufassa F,Lopez P,Lecuroux C,Noel N,Trémeaux P,Monceaux V,Autran B,Meyer L,Saez-Cirion A,Lambotte O,Rouzioux C,CODEX ANRS Cohort Study Group.

    更新日期:2019-01-01 00:00:00

  • High rate of loss to clinical follow up among African HIV-infected patients attending a London clinic: a retrospective analysis of a clinical cohort.

    abstract:BACKGROUND:Long-term regular clinic follow up is an important component of HIV care. We determined the frequency and characteristics of HIV-infected patients lost to follow up from a London HIV clinic, and factors associated with loss to all HIV follow up in the UK. METHODS:We identified 1859 HIV-infected adults who h...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1186/1758-2652-13-29

    authors: Gerver SM,Chadborn TR,Ibrahim F,Vatsa B,Delpech VC,Easterbrook PJ

    更新日期:2010-08-04 00:00:00

  • Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services.

    abstract:INTRODUCTION:Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. METHODS:We systematically reviewed studies reporting interventions for reducing HIV transmission among f...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章,评审

    doi:10.7448/IAS.16.1.17980

    authors: Chersich MF,Luchters S,Ntaganira I,Gerbase A,Lo YR,Scorgie F,Steen R

    更新日期:2013-03-04 00:00:00

  • What makes orphans in Kigali, Rwanda, non-adherent to antiretroviral therapy? Perspectives of their caregivers.

    abstract:INTRODUCTION:Every year, approximately 260,000 children are infected with HIV in low- and middle-income countries. The timely initiation and high level of maintenance of antiretroviral therapy (ART) are crucial to reducing the suffering of HIV-positive children. We need to develop a better understanding of the backgrou...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.17.1.19310

    authors: Kikuchi K,Poudel KC,Muganda J,Sato T,Mutabazi V,Muhayimpundu R,Majyambere A,Nyonsenga SP,Sase E,Jimba M

    更新日期:2014-12-03 00:00:00

  • How far are we from viral hepatitis elimination service coverage targets?

    abstract:INTRODUCTION:In 2016, the Global Health Sector Strategy (GHSS) on viral hepatitis called for elimination of viral hepatitis as a major public health threat by 2030 (i.e. 90% reduction in incidence and 65% in mortality). In 2017, WHO's first-ever Global Hepatitis Report presented the baseline values for each of the core...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章,评审

    doi:10.1002/jia2.25050

    authors: Hutin YJ,Bulterys M,Hirnschall GO

    更新日期:2018-04-01 00:00:00

  • Treatment as prevention: preparing the way.

    abstract::Potent antiretroviral therapy (ART) reduces mortality and morbidity in people living with HIV by reducing viral load and allowing their immune systems to recover. The reduction in viral load soon after starting ART has led to the hypothesis that early and widespread ART could prevent onward transmission and therefore ...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1186/1758-2652-14-S1-S6

    authors: Williams B,Wood R,Dukay V,Delva W,Ginsburg D,Hargrove J,Stander M,Sheneberger R,Montaner J,Welte A

    更新日期:2011-07-06 00:00:00

  • Prevalence of HIV among injection drug users in Georgia.

    abstract:BACKGROUND:Injection drug use remains a major risk factor for HIV transmission in Georgia. The study aims to characterize the prevalence of HIV among injection drug users in Georgia. METHODS:A cross-sectional, anonymous bio-behavioural survey to assess knowledge and behaviour in injection drug users in combination wit...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1186/1758-2652-14-9

    authors: Chikovani I,Goguadze K,Ranade S,Wertlieb M,Rukhadze N,Gotsadze G

    更新日期:2011-02-15 00:00:00

  • Routine viral load monitoring in HIV-infected infants and children in low- and middle-income countries: challenges and opportunities.

    abstract:INTRODUCTION:The objective of this commentary is to review considerations for implementing routine viral load (VL) monitoring programmes for HIV-infected infants and children living in low- and middle-income countries (LMIC). Since 2013, the World Health Organization (WHO) guidelines recommend VL testing as the preferr...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1002/jia2.25001

    authors: Arpadi SM,Shiau S,De Gusmao EP,Violari A

    更新日期:2017-11-01 00:00:00

  • Access to antiretroviral therapy and survival in eastern Europe and central Asia: a case study in Armenia.

    abstract:INTRODUCTION:Antiretroviral therapy (ART) substantially improves the health of people living with HIV and contributes to preventing new infections. While HIV incidence is decreasing in most regions, the epidemic in eastern Europe continues to rise, as new infections currently outnumber the rate of ART initiation. In th...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.17.1.18795

    authors: Mallitt KA,Grigoryan SR,Papoyan AS,Wand HC,Wilson DP

    更新日期:2014-08-04 00:00:00

  • Investigating combination HIV prevention: isolated interventions or complex system.

    abstract:INTRODUCTION:Treatment as prevention has mobilized new opportunities in preventing HIV transmission and has led to bold new UNAIDS targets in testing, treatment coverage and transmission reduction. These will require not only an increase in investment but also a deeper understanding of the dynamics of combining behavio...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.18.1.20499

    authors: Brown G,Reeders D,Dowsett GW,Ellard J,Carman M,Hendry N,Wallace J

    更新日期:2015-12-14 00:00:00

  • Hypovitaminosis D in HIV-infected patients in Lisbon: a link with antiretroviral treatment.

    abstract:INTRODUCTION:Recent data indicates that low vitamin D (25(OH)D) levels can lead to a worst prognosis in HIV-infected individuals, even in those on successful antiretroviral therapy (ART) [1]. Portugal is the European country that has the largest average sun exposure time but prevalence of hypovitaminosis D is mostly un...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.17.4.19826

    authors: Boura M,Sutre AF,Badura R,Zagalo A,Afonso C,Caldeira L,Valadas E

    更新日期:2014-11-02 00:00:00

  • HIV knowledge trends during an era of rapid antiretroviral therapy scale-up: an analysis of 33 sub-Saharan African countries.

    abstract:INTRODUCTION:Population-level improvements in knowledge about HIV may reduce the stigma attached to HIV and ensure maximal uptake of HIV prevention initiatives. The extent to which levels of HIV knowledge in the general population of sub-Saharan Africa have changed in the current era of antiretroviral therapy (ART) sca...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1002/jia2.25169

    authors: Chan BT,Tsai AC

    更新日期:2018-07-01 00:00:00

  • The 2016 HIV diagnosis and care cascade in New South Wales, Australia: meeting the UNAIDS 90-90-90 targets.

    abstract:INTRODUCTION:The HIV Strategy in New South Wales (NSW) Australia aims to virtually eliminate HIV transmission by 2020. We estimated the 2016 HIV diagnosis and care cascade for the state of NSW, with a focus on introducing population-based data to improve data quality and assess progress towards the UNAIDS 90-90-90 targ...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.1002/jia2.25109

    authors: Keen P,Gray RT,Telfer B,Guy R,Schmidt HM,Whittaker B,Holden J,Holt M,Kelleher A,Wilson D,Callander D,Cooper DA,Prestage G,Selvey C,Grulich AE,NSW HIV Prevention Partnership Project.

    更新日期:2018-04-01 00:00:00

  • Barriers and facilitators to linkage to ART in primary care: a qualitative study of patients and providers in Blantyre, Malawi.

    abstract:INTRODUCTION:Linkage from HIV testing and counselling (HTC) to initiation of antiretroviral therapy (ART) is suboptimal in many national programmes in sub-Saharan Africa, leading to delayed initiation of ART and increased risk of death. Reasons for failure of linkage are poorly understood. METHODS:Semi-structured qual...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.15.2.18020

    authors: MacPherson P,MacPherson EE,Mwale D,Bertel Squire S,Makombe SD,Corbett EL,Lalloo DG,Desmond N

    更新日期:2012-12-31 00:00:00

  • Long-term effect of a four-drugs induction regimen for patients with high baseline viral load.

    abstract:INTRODUCTION:The long-term effects of an intensified induction regimen are unknown. In this pilot, randomized, prospective study we evaluate the effect of a short-term four-drugs induction regimen in patients with high baseline viral load. METHODS:Naive patients with HIV-RNA>100.000 copies/ml receiving TDF+FTC+EFV+RAL...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.17.4.19776

    authors: Maggiolo F,Masini G,Astuti N,Di Filippo E,Benatti S,Valenti D,Callegaro AP,Rizzi M

    更新日期:2014-11-02 00:00:00

  • Effect of multiple micronutrient supplementation on survival of HIV-infected children in Uganda: a randomized, controlled trial.

    abstract:BACKGROUND:Micronutrient deficiencies compromise the survival of HIV-infected children in low-income countries. We assessed the effect of multiple micronutrient supplementation on the mortality of HIV-infected children in Uganda. METHODS:In a randomized, controlled trial, 847 children aged one to five years and attend...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/1758-2652-13-18

    authors: Ndeezi G,Tylleskär T,Ndugwa CM,Tumwine JK

    更新日期:2010-06-03 00:00:00

  • "We don't need services. We have no problems": exploring the experiences of young people who inject drugs in accessing harm reduction services.

    abstract:INTRODUCTION:Evidence suggests that people who inject drugs often begin their drug use and injecting practices in adolescence, yet there are limited data available on the HIV epidemic and the responses for this population. The comprehensive package of interventions for the prevention, treatment and care of HIV infectio...

    journal_title:Journal of the International AIDS Society

    pub_type: 杂志文章

    doi:10.7448/IAS.18.2.19442

    authors: Krug A,Hildebrand M,Sun N

    更新日期:2015-02-26 00:00:00