Infant Early Diagnosis of HIV
Without antiretroviral therapy, up to 40% of HIV infected children in resource limited settings will die by their first birthday, rising to 50% by two years of age. A 76% reduction in early infant mortality has been demonstrated, when antireatroviral treatment was initiated in the first 12 weeks of life, prior to presentation no clinical symptoms or immunolodeficiency.
In the past few years a new technique has been developed for early diagnosis of HIV infection. This technique, called HIV DNA PCR is extremely sensitive and can detect the virus from a very small amount of blood collected and dried on filter paper. Using this in-house, low cost technique, it is now possible know if a child is infected from just 2 months of age.
With support from NGOs Sidaction, Oxfam GB and the Global Fund, a technology transfer program was established between PHPT and the Division of Clinical Microbiology at the Faculty of Associated Medical Sciences, Chiang Mai University. The early diagnosis service was piloted in a network of 35 public hospitals throughout Thailand. The child’s blood sample is collected on special filter paper, dried and sent by regular mail to the Chiang Mai University Laboratory. The test results given within one month, all infants are tested twice for confirmation.
With this test, families can be sure that infants confirmed as HIV negative do not need specialized care. For the few children who are HIV infected, this early diagnosis can greatly improve their chances of survival, as they can start antiretroviral treatment as soon as it is needed. Early diagnosis of HIV for infants born to HIV infected mothers is now provided free as part of standard care, supported by the National Health Security Office.
A study was performed to assess the performance of a low-cost in-house real-time polymerase chain reaction (PCR) assay to detect HIV-1 DNA in infant dried blood spots (DBS) which found that combined use of DBS and real-time PCR assays is a reliable and affordable tool to expand access to early HIV-1 diagnosis in remote and resource-limited settings, enabling timely treatment for HIV-1-infected infants.