Predicting in utero HIV infection in newborns

HIV symptoms in newborns and insufficient prenatal care, limited antiretroviral therapy, and high viral load in mothers increased the likelihood of in utero infection.

Successful programs are in place worldwide to prevent mother-to-infant HIV transmission that occurs around the time of birth, but some infants are infected prior to delivery, typically resulting in early disease progression.

Universal testing of infants in areas with high maternal infection rates identifies infected infants after the first month of life, but for infants infected in utero, earlier detection would allow for earlier antiretroviral therapy (ART).

To determine maternal and infant characteristics associated with high risk for in utero HIV infection, investigators studied HIV-infected mothers and 1691 infants who received HIV polymerase chain reaction (PCR) testing at birth at a tertiary hospital in Pretoria, South Africa, where the rate of HIV in women giving birth was 22%.

Infants had excess risks for positive HIV PCR results if they were symptomatic at birth (such as with growth restriction, anemia, or pneumonia) or if their mothers had <3 prenatal care visits, <4 weeks of ART, or viral loads ≥1000 copies/mL.

These findings show that maternal and infant factors can help identify newborns who should be tested at birth for in utero HIV transmission, particularly in resource-limited areas with high rates of maternal HIV infection.

Nigeria has more HIV-infected babies than anywhere in the world. It’s a distinction no country wants.

Tareq Salahuddin

Dr. Tareq Salahuddin is an award-winning journalist and a Special Correspondent of News Hour. He is a Public Health Professional working in the development sector. Dr. Tareq, a medical graduate, is a member of Public Health Association of Bangladesh and a former member of the Governing Council and Policy Committee of the World Federation of Public Health Associations (WFPHA), a J2J Fellow on HIV/AIDS and a member of the International AIDS Society. To know more about Dr. Tareq, please visit his personal website (www.tareqsalahuddin.net) or simply Google his name.
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