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Vertical transmission of HIV among pregnant women who initially had false-negative rapid HIV tests in four South African antenatal clinics.
- Source :
-
PloS one [PLoS One] 2019 Dec 20; Vol. 14 (12), pp. e0226391. Date of Electronic Publication: 2019 Dec 20 (Print Publication: 2019). - Publication Year :
- 2019
-
Abstract
- Introduction: There is a risk of mother-to-child transmission of HIV (MTCT) during pregnancy and breastfeeding. The aim of this study was to assess vertical transmission of HIV among pregnant women who initially had false-negative rapid HIV tests in South African antenatal care (ANC) clinics.<br />Methods: Pregnant participants were enrolled in a diagnostic study that used nucleic acid amplification testing (NAAT) to screen for early HIV infection among individuals who tested negative on rapid HIV tests used at the point-of-care (POC) facilities. Participants were enrolled from four ANC clinics in the Tshwane district of South Africa. All NAAT-positive participants were recalled to the clinics for further management. Vertical transmission was assessed among exposed infants whose HIV polymerase chain reaction (PCR) results were available.<br />Results: This study enrolled 8208 pregnant participants who tested negative on rapid HIV tests between 2013 and 2016. Their median age was 26 years (interquartile range [IQR]: 23-30). NAAT detected HIV infections in 0.6% (n = 49; 95% confidence interval {CI}: 0.5-0.8) of all study participants. The distribution of these infections among the four clinics ranged from 0.3%- 1.1%, but this was not statistically significant (p = 0.07). Forty-seven participants (95.9%) were successfully recalled and referred for antiretroviral treatment initiation as part of prevention of MTCT (PMTCT). Most women with newly diagnosed HIV infection presented for the first ANC visit in the second (61.9%, n = 26) and third (31.0%, n = 13) trimesters. HIV PCR results were available for thirty-two infants, three of whom tested positive (9.4%; 95% CI: 1.98-25.02).<br />Conclusions: This study showed that supplemental HIV testing for pregnant women led to earlier linkage to the PMTCT programme. Inaccurate diagnosis of HIV infection at ANC clinics is likely to undermine the efforts of eliminating MTCT particularly in HIV-endemic settings.<br />Competing Interests: Toga Laboratories provided support in the form of salaries for DJM. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
- Subjects :
- Adult
False Negative Reactions
Female
HIV Infections drug therapy
HIV Infections transmission
Humans
Infant
Infectious Disease Transmission, Vertical prevention & control
Mass Screening
Maternal Age
Nucleic Acid Amplification Techniques
Point-of-Care Systems
Pregnancy
Pregnancy Complications, Infectious drug therapy
Prenatal Care methods
South Africa
Young Adult
Anti-HIV Agents therapeutic use
HIV genetics
HIV Infections diagnosis
Infectious Disease Transmission, Vertical statistics & numerical data
Pregnancy Complications, Infectious virology
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 14
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 31860677
- Full Text :
- https://doi.org/10.1371/journal.pone.0226391