Download Free Medical DOES HIV-PCR TESTING OF HIV-EXPOSED INFANTS AT BIRTH REDUCE FOLLOW-UP FOR TESTING AT 4 -14 WEEKS OF AGE? PowerPoint Presentation

DOES HIV-PCR TESTING OF HIV-EXPOSED INFANTS AT BIRTH REDUCE FOLLOW-UP FOR TESTING AT 4 -14 WEEKS OF AGE? PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : DOES HIV-PCR TESTING OF HIV-EXPOSED INFANTS AT BIRTH REDUCE FOLLOW-UP FOR TESTING AT 4 -14 WEEKS OF AGE?

Tags : Pediatrics, Child Health, pediatric practice, pediatrician, health providers, HIV-infected infants, Adolescent Transition, HIV-infected adolescents, epidemiology, south Africa, HIV-PCR TESTING

Published on : Jul 16, 2020 | Views : 1435 | Downloads : 0

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

DOES HIV-PCR TESTING OF HIV-EXPOSED INFANTS AT BIRTH REDUCE FOLLOW-UP FOR TESTING AT 4 -14 WEEKS OF AGE? Emma Kalk, Max Kroon, Andrew Boulle, Meg Osler, Jonathan Euvrard, Kathryn Stinson, Venessa Timmerman & Mary-Ann Davies
Slide 2-

6 weeks 10 weeks Post breast-feeding In utero & intrapartum Post-partum Globally, in 2014 only 50% of infants were tested by 2 months. ART delayed in HIV-infected infants. 6 week time-point is not validated in presence of extended infant drug prophylaxis.
Slide 3-

6 weeks 10 weeks Post breast-feeding In utero & intrapartum Post-partum Detect 75% of infants who will test positive at 6 weeks. Detect infants at high risk of rapid progression. Birth In utero
Slide 4-

BACKGROUND A caveat to HIV testing at birth is that a second PCR will be required to detect late intra-partum and post-natal infections in addition to testing after cessation of breast- feeding. OBJECTIVE To determine whether a negative birth HIV-PCR result decreased follow-up for routine testing at 4-14 weeks.
Slide 5-

METHODS Infants born to a cohort of HIV-infected women Antenatal care at Mitchell’s Plain Midwife Obstetric Unit Delivery: MP MOU and its 3 referral hospitals February 2014 – March 2015 Analysis: logistic regression Outcome: HIV-PCR test result @ 4 – 14 weeks Adjusted for other predictors of routine testing @ 4 – 14 weeks
Slide 6-

METHODS Testing algorithm at the time: Routine HIV-PCR all exposed infants @ 4 – 6 weeks old August 2014: targeted birth HIV-PCR – high-risk criteria HIGH-RISK CRITERIA FOR VERTICAL HIV INFECTION BIRTH PCR INDICATED Maternal ART for less than 3 months before delivery Maternal viral load > 1000 copies/ml or unknown Infant less than 37 weeks completed gestation Birth weight less than 2.5 kg
Slide 7-

ppt slide no 7 content not found
Slide 8-

RESULTS 870 mother-infant pairs 49% ≥ 1 high-risk criterion 18% of these were tested at birth Increasing number of high-risk criteria increased the likelihood of having a birth HIV-PCR 5% if no risk factors 15% if one risk factor 32% if ≥ 2 risk factors
Slide 9-

RESULTS Overall vertical transmission: 1.2% 74% of the cohort had an HIV-PCR at 4 – 14 weeks 3.96% birth HIV-PCR positive versus 0.31% at 4 – 14 weeks
Slide 10-

RESULTS
Slide 11-

birth PCR 19.7% 15% 25.9% 45.2% Timing of HIV testing by high-risk criteria
Slide 12-

RESULTS – logistic regression
Slide 13-

Limitations May not be generalizable outside the Western Cape. Used laboratory data: an HIV-PCR result does not guarantee receipt of result by care-giver. Reason for non-return for routine test may be owing to illness/death. Future: link to admissions and mortality data
Slide 14-

CONCLUSIONS In this South African cohort, half of HIV-exposed infants had at least one high-risk criterion for vertical HIV transmission. The proportion who received a birth HIV-PCR was low (<20%). 74% of exposed infants had an HIV-PCR at 4 – 14 weeks. Nearly 4% of birth HIV-PCRs were positive. Receipt of a negative birth HIV-PCR result was associated with reduced follow-up testing at 4-14 weeks. Strengthened follow-up systems are needed to ensure adequate early infant diagnosis coverage.
Slide 15-

ACKNOWLEDGEMENTS Vumela Mzangwe, Kungeka Ndindwa, Ranga Matima & Jess Barker on the CTG team Marvin Hsiao at the NHLS Staff and patients of MP MOU and referral hospitals Supported by the NICHD: R01 HD075156 (Mary-Ann Davies)

User Presentation
Related Presentations

High-Resource Perspective on Adolescent Transition and Research Priorities

By: MarieAltmann
Views: 1956

Virological response and resistance among HIV-infected children on first-line antiretroviral therapy without routine virological monitoring

By: MarieAltmann
Views: 2423

OUTCOMES OF HIV EXPOSED INFANTS BEFORE AND AFTER IMPLEMENTING OPTION B Plus PMTCT GUIDELINE IN KAMPALA

By: MarieAltmann
Views: 1546

Impact of birth HIV PCR testing on uptake of follow-up EID services for HIV-exposed infants in Cape Town

By: MarieAltmann
Views: 1543

High Retention and Viral Suppression Rates Among HIV-infected Adolescents Attending an Adolescent- friendly Clinic in South Africa

By: MarieAltmann
Views: 1599

Developmental Milestones and Recognizing Delays

By: drdwayn
Views: 2928

SINDROM NEFROTIK

By: habibieelr
Views: 3548

BURNS IN PEDIATRICS

By: drdwayn
Views: 5567

Growing Up

By: medhelp
Views: 1147

Introduction to Behavioral Pediatrics

By: drdwayn
Views: 1320

MarieAltmann

About : I am a passionate Pediatrician with experience of working in world-renowned hospital systems as well as community-based clinics. I have skills like Advocacy, Team Building, Event Planning, and Public Speaking. A dedicated and worthy healthcare services professional with a MPH focused in International studies from Tulane School of Public Health and Tropical Medicine.
Occupation : Medical Professional
Specialty : MD
Country : United States of America
Website :

HEALTH A TO Z