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Early infant diagnosis: gateway to survival for HIV positive infants

Background

Under PPTCT, babies born to sero-positive mothers were followed up and tested at 18 months of age. Under Early Infant Diagnosis (EID) program, HIV exposed babies are subjected to HIV-1 DNA PCR on DBS and whole blood as early as 6 weeks of age followed by initiation of ART.

Methods

Infants born to HIV positive mothers were tested according to NACO guidelines. Infants <6 months of age (n=136) were tested by DBS HIV-1 DNA PCR; DBS positive were confirmed by whole blood PCR. Infants 6 to 18 months (n=68) were tested by antibody test and if positive were confirmed by DBS HIV-1 DNA PCR. Detailed history including type of delivery, Single Dose Nevirapine (SDN) and breast feeding was taken.

Results

The HIV transmission rate was 11.28% (23/204); 13 infants <6 months of age and 10 infants ≥6 months of age. In infants <6 months of age, who did not receive SDN the positivity was 38.46% (5/13) whereas in those who received SDN it was 6.5% (8/123), [p=0.0012]. In infants ≥6 months the positivity rate was significantly higher in breast fed 60% (6/10) as compared to non breast fed 6.9% (4/58),[p=0.0001]. 60.9% (14/23) infants were delivered at home and did not receive SDN.

Conclusion

In resource limited settings, SDN given to mother in labor is a good option.. Mothers intending to continue breast feeding should be provided extended ART. EID and prompt ART institution ensures favourable outcomes in HIV exposed infants.

Author information

Correspondence to Jayanthi Shastri.

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Keywords

  • Nevirapine
  • Breast Feeding
  • Resource Limited Setting
  • Positive Mother
  • Exposed Infant