Call for earlier HIV tests for infants

Researchers are calling for early HIV-testing of breastfed babies born to HIV-positive mothers which, they say, would not only result in early diagnosis in cases of transmission, but could prevent complicated infections and mortality in what is regarded as a vulnerable group.

Cape Argus, 21 September 2015

Early testing has also been associated with reducing the number of follow-up viral load tests, which are considered costly. A study by researchers from Wits and Columbia universities cautioned that while South Africa had made great strides in preventing mother-to-child transmission, with more than 90 percent of pregnant women accessing treatment, the detection of postnatal transmission still faces challenges. While the country was on track to meet its target of less than two percent of transmissions this year, researchers warned that HIV-testing after weaning remained poorly implemented and monitored.

Exclusive breastfeeding for the first six to 12 months of a baby's life under antiretroviral therapy for HIV-exposed babies has been recommended since 2010. But the country's HIV-testing of these babies has not been in line with the policies of the World Health Organisation, which recommends a rapid HIV screening test at the nine-month immunisation visit with a confirmatory test if the test is positive. While babies born to HIV-positive mothers were tested for HIV at six weeks, there was no HIV test scheduled for these babies for another year unless they were weaned early or showed "symptoms of the disease".

Under the current guidelines, all infants who start breastfeeding required one HIV test after being weaned at about 13 months or six weeks after the cessation of breastfeeding. In a study, published in the SA Medical Journal, researchers screened about 100 breastfed babies at nine months, and again at 18 months for those who were still breastfed at 12 months. Results showed that by testing these babies early, HIV infection could be detected much earlier. However, there was a reduction in the number of follow-up tests by 50 percent. This was not only associated with reduced costs associated with "viral-load testing", but also eliminated the need for follow-up visits.