An analysis of the HIV testing cascade of a group of HIV-exposed infants from birth to 18 months in peri-urban Khayelitsha, South Africa.
An analysis of the HIV testing cascade of a group of HIV-exposed infants from birth to 18 months in peri-urban Khayelitsha, South Africa.
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DOI：
10.1371/journal.pone.0262518
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Maritz J
中科院分区：
文献类型：
--
作者：
Nelson AK;Cassidy T;Trivino Duran L;Cox V;Wedderburn CJ;Giddy J;Pieters P;Cotton MF;Mutseyekwa T;Rorwana B;Sibanda B;Bernheimer J;Matise N;Isaakidis P;Maritz J
尽管艾滋病毒母婴传播有所减少，但母乳喂养期间的传播率仍令人关切。我们描述了常规摄取6或10（6/10）周，9个月和18个月的测试，有和没有跟踪，在出生时接受HIV PCR检测（出生PCR）（有和没有床旁（POC）检测）的婴儿队列在城市周边的初级卫生保健设置在Khayelitsha，南非。在2014年11月至2018年2月进行的这项队列研究中，HIV阳性母亲及其HIV暴露婴儿在出生时被招募，所有婴儿都接受了出生PCR检测。通过患者示踪剂对常规6/10周PCR、9个月和18个月测试的结果进行随访。我们将6/10周时的检测与未进行出生PCR检测的历史队列亚组进行了比较。我们发现，6/10周测试的吸收率为77%，而追踪的吸收率为82%。当包括级联中的所有婴儿并与没有出生测试的历史队列进行比较时，我们发现，与出生时未进行测试的婴儿相比，进行出生测试的婴儿进行6/10周测试的可能性高出22%。出生后6/10周PCR POC检测与出生后无POC PCR检测之间无显著差异。9个月和18个月的吸收率分别为39%和24%。随着追踪工作的加强，吸收率分别增加到45%和34%。在出生后头18个月接受艾滋病毒暴露的未感染婴儿的艾滋病毒检测显示，6/10周PCR完成情况良好，但在9个月和18个月接受艾滋病毒检测的情况不佳，尽管进行了追踪。与没有出生PCR检测相比，出生PCR检测对6/10周HIV检测的摄取没有负面影响。
Despite the reduction of HIV mother-to-child transmission, there are concerns regarding transmission rate in the breastfeeding period. We describe the routine uptake of 6 or 10 (6/10) weeks, 9 months and 18 months testing, with and without tracing, in a cohort of infants who received HIV PCR testing at birth (birth PCR) (with and without point of care (POC) testing) in a peri-urban primary health care setting in Khayelitsha, South Africa. In this cohort study conducted between November 2014 and February 2018, HIV-positive mothers and their HIV-exposed babies were recruited at birth and all babies were tested with birth PCR. Results of routine 6/10 weeks PCR, 9 months and 18 months testing were followed up by a patient tracer. We compared testing at 6/10 weeks with a subgroup from historical cohort who was not tested with birth PCR. We found that the uptake of 6/10 weeks testing was 77%, compared to 82% with tracing. When including all infants in the cascade and comparing to a historical cohort without birth testing, we found that infants who tested a birth were 22% more likely to have a 6/10 weeks test compared to those not tested at birth. There was no significant difference between the uptake of 6/10 weeks testing after birth PCR POC versus birth PCR testing without POC. Uptake of 9 months and 18 months testing was 39% and 24% respectively. With intense tracing efforts, uptake increased to 45% and 34% respectively. Uptake of HIV testing for HIV-exposed uninfected infants in the first 18 months of life shows good completion of the 6/10 weeks PCR but suboptimal uptake of HIV testing at 9 months and 18 months, despite tracing efforts. Birth PCR testing did not negatively affect uptake of the 6/10 weeks HIV test compared to no birth PCR testing.
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