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Implementation and Uptake of Raltegravir Granules in Newborns Diagnosed With HIV Through Birth Testing in Maternity

Lise Denoeud-Ndam1, Carl Stecker2, Precious Andifasi3

  • 1From the Elizabeth Glaser Pediatric AIDS Foundation, Geneva, Switzerland.

The Pediatric Infectious Disease Journal
|March 31, 2023
PubMed

Insights

Zimbabwe

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Zimbabwe implemented point-of-care HIV testing for newborns to provide timely antiretroviral treatment.
  • Raltegravir (RAL) granules were introduced to initiate HIV-positive newborns on a RAL-based regimen.
  • The goal was to improve early infant diagnosis and treatment outcomes for HIV-exposed infants.

Purpose of the Study:

  • To evaluate the implementation and outcomes of a raltegravir (RAL) granule program for HIV-positive newborns in Zimbabwe.
  • To assess the uptake of RAL initiation among diagnosed infants.
  • To identify challenges affecting program implementation and testing coverage.

Main Methods:

  • A retrospective analysis of HIV-exposed newborns tested between June 2020 and July 2021 at 14 Zimbabwean facilities.
  • Data collection on HIV testing rates, diagnosis, and initiation of RAL treatment.
  • Assessment of factors influencing program uptake, including the impact of the COVID-19 pandemic.

Main Results:

  • Of 6989 HIV-exposed newborns, 3172 (45%) were tested.
  • 59 (2%) newborns were diagnosed with HIV infection.
  • Only 27 (46%) of diagnosed infants initiated RAL treatment.
  • Low birth testing, RAL uptake, and 6-month viral load testing were observed.

Conclusions:

  • The implementation of RAL granules faced significant challenges in Zimbabwe, with suboptimal uptake.
  • The COVID-19 pandemic negatively impacted supply chains and healthcare provider availability, hindering program success.
  • Strategies are needed to improve HIV testing, RAL initiation, and viral load monitoring in newborns.

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