1. High mortality in HIV-infected children diagnosed in hospital underscores need for faster diagnostic turnaround time in prevention of mother-to-child transmission of HIV (PMTCT) programs
- Author
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Anjuli D. Wagner, Irene N. Njuguna, Irene Inwani, Dalton Wamalwa, Grace John-Stewart, Ken Tapia, Judith Adhiambo, Sarah Benki-Nugent, Jennifer A. Slyker, and Agnes Langat
- Subjects
Pediatrics ,medicine.medical_specialty ,Delayed Diagnosis ,Anti-HIV Agents ,Population ,PMTCT ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,Turnaround time ,Hospital ,Hiv infected ,medicine ,Prevalence ,Humans ,Pediatrics, Perinatology, and Child Health ,Symptom onset ,Longitudinal Studies ,education ,Pediatric ,education.field_of_study ,business.industry ,High mortality ,Prevention of mother to child transmission ,virus diseases ,Infant ,HIV ,Early infant diagnosis ,Kenya ,Infectious Disease Transmission, Vertical ,3. Good health ,Child mortality ,Early Diagnosis ,Pediatrics, Perinatology and Child Health ,business ,Research Article - Abstract
Background Despite expanded programs for prevention of mother-to-child HIV transmission (PMTCT), HIV-infected infants may not be diagnosed until they are ill. Comparing HIV prevalence and outcomes in infants diagnosed in PMTCT programs to those in hospital settings may improve pediatric HIV diagnosis strategies. Methods HIV-exposed infants 3 times as likely to die (HR = 3.1, 95% CI = 1.3-7.6). Conclusions Among HIV-exposed infants, hospital-based testing was more likely to detect an HIV-infected infant than PMTCT testing. Because young symptomatic infants diagnosed with HIV during hospitalization have very high mortality, every effort should be made to diagnose HIV infections before symptom onset. Systems to expedite turnaround time at PMTCT EID sites and to routinize inpatient pediatric HIV testing are necessary to improve pediatric HIV outcomes.
- Published
- 2015