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Oral fluid tests for screening of human immunodeficiency virus-exposed infants
Gayle G Sherman1, Rivka R Lilian, Ashraf H Coovadia
1Department of Molecular Medicine and Haematology, Medical School, University of the Witwatersrand, Parktown, Johannesburg, South Africa. gayle.sherman@nhls.ac.za
Insights
Routine infant screening for human immunodeficiency virus (HIV) using rapid oral fluid tests showed less than 90% sensitivity. This means over 10% of HIV-infected infants were missed, delaying crucial early diagnosis and intervention.
Area of Science:
- Pediatric infectious diseases
- Diagnostic test evaluation
- Public health screening
Background:
- High human immunodeficiency virus (HIV) prevalence settings necessitate early infant diagnosis.
- Routine infant screening at immunization visits can identify HIV-exposed infants for timely intervention.
Purpose of the Study:
- To assess the performance of two rapid oral fluid HIV tests for early infant screening.
- To determine the sensitivity of these tests in identifying HIV exposure in infants.
Main Methods:
- Evaluation of two rapid oral fluid HIV diagnostic tests.
- Testing conducted in infants in high HIV prevalence settings.
Main Results:
- The rapid oral fluid HIV tests demonstrated a sensitivity of less than 90%.
- At least 1 in 10 HIV-infected infants were not detected by the tested methods.
Conclusions:
- Current rapid oral fluid HIV tests may not be sufficiently sensitive for routine infant screening in high-prevalence areas.
- Improved diagnostic strategies are needed to ensure early detection of HIV in all infants.
Abstract:
In high human immunodeficiency virus (HIV) prevalence settings, routine screening of infants attending immunization visits could improve identification of HIV-exposed infants to receive an early diagnosis and appropriate interventions. This first assessment of 2 rapid oral fluid HIV tests in early infancy demonstrates a sensitivity of <90% for detection of HIV-exposure resulting in failure to detect at least 1 in 10 HIV-infected infants.
