Timing of HIV seroreversion among HIV-rxposed, breastfed infants in Malawi : type of HIV rapid test matters

Autor: William C. Miller, Queen Dube, Michael G. Hudgens, Julie A. E. Nelson, Emily R. Smith, Annelies Van Rie, Stephanie B. Wheeler, Anna D. Sheahan
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Adult
Male
0301 basic medicine
Malawi
Pediatrics
medicine.medical_specialty
Epidemiology
Point-of-care testing
030106 microbiology
Breastfeeding
HIV Infections
Context (language use)
Serology
03 medical and health sciences
0302 clinical medicine
HIV Seropositivity
Obstetrics and Gynaecology
Humans
Mass Screening
Medicine
030212 general & internal medicine
Pediatrics
Perinatology
and Child Health
Prospective cohort study
Mass screening
Prevention of mother-to-child transmission
business.industry
Public Health
Environmental and Occupational Health
Infant
Obstetrics and Gynecology
Early infant diagnosis
Infectious Disease Transmission
Vertical
3. Good health
Test (assessment)
HIV transmission
Diagnostic testing
Breast Feeding
Point-of-Care Testing
Pediatrics
Perinatology and Child Health
Female
Brief Reports
Human medicine
business
Breast feeding
Zdroj: Maternal and child health journal
Maternal and Child Health Journal
ISSN: 1092-7875
Popis: Introduction Rapid HIV serological tests are a cost-effective, point-of-care test among HIV exposed infants but cannot distinguish between maternal and infant antibodies. The lack of data on the timing of decay of maternal antibodies in young infants hinders the potential use of rapid tests in exposed infants. We aimed to determine the time to seroreversion for two commonly used rapid tests in a prospective cohort of HIV-exposed breastfeeding infants ages 3-18 months of life. Methods We collected data on the performance of two commonly used rapid tests (Determine and Unigold) in Malawi between 2008 and 2012 or at the University of North Carolina between 2014 and 2015. Time to seroreversion was estimated for both rapid tests using the Kaplan-Meier product limit estimator which allows for interval censored data. Results At 3 months of age, 3 % of infants had seroreverted according to Determine and 7 % had seroreverted according to Unigold. About one in four infants had achieved seroreversion by 4 months using Unigold, but only about one in twelve infants by 4 months when using Determine. More than 95 % of all infants had seroverted by 7 months according to Unigold and by 12 months according to the Determine assay. Discussion We show that the time of seroreversion depends greatly on the type of test used. Our results highlight the need for recommendations to specify the timing and type of test used in the context of infant HIV detection in resource-poor settings, and base the interpretation of test result on knowledge of time to seroreversion of the selected test.
Databáze: OpenAIRE
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