Why is early infant diagnosis a priority?
Overall prevention of mother-to-child transmission of HIV, has been one of the biggest successes of the HIV response. We now see more mothers taking antiretroviral treatment (ART) and HIV infections among children are falling.
However, progress in early infant testing has been much slower. In 2018, less than 50% of babies had been tested for HIV in their first 8 weeks, and only 50% of children living with HIV had started ART in most regions. This is now one of the biggest priorities for HIV care providers. Without being tested and getting treatment young babies face high risks of death or serious illness. Improving testing will ensure that more babies with HIV can go on to live long and healthy lives.
What is point-of-care diagnosis and how can it help?
In many places, there can be long delays between when a baby gets their test done and when their results are ready to collect. This is because samples have to be sent to laboratories - which are often far away - to get results.
These long wait times delay infants from being able to start treatment, and in some cases can mean that results are never collected and children are left undiagnosed.
The World Health Organization recommends that infants' test results are returned to families no later than 30 days after the baby was tested. However, average wait times can be as high as 55 days, meaning that babies are often not initiated on ART for the crucial first months when their risk of death is highest.
New point-of-care testing devices mean that infant test samples don't have to be sent away to laboratories for processing. Instead, healthcare workers at clinics can process the tests themselves and provide families with results. This means that the results can be returned to families on the same day, and babies can start treatment quickly. This avoids results never being collected and children being left undiagnosed.
These tests are already being used in some clinics in Zimbabwe, Kenya, Malawi, Tanzania, South Africa, and Mozambique, where they've had amazing results. In one case, the proportion of babies starting ART within 60 days increased from 43.3% with laboratory testing to 92.3% after point-of-care testing was introduced.
Point-of-care testing often works out cheaper, and some devices can also provide viral load and TB testing too.