The development of an inexpensive, simple and widely accessible test for diagnosing human immunodeficiency virus (HIV) infection in infants could significantly reduce paediatric acquired immunodeficiency syndrome (AIDS) deaths in sub-Saharan Africa.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 51 print issues and online access
$199.00 per year
only $3.90 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
The Joint United Nations Programme on HIV/AIDS and World Health Organization. Aids Epidemic Update: December 2005 — Special Section on HIV Prevention (UNAIDS, Geneva, 2005).
World Health Organization. The World Health Report 2005: Making Every Mother and Child Count (WHO, Geneva, 2005).
The Joint United Nations Programme on HIV/AIDS. 2004 Report on the Global AIDS Epidemic: 4th Global Report (UNAIDS, Geneva, 2004).
Newell, M. L. et al. Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: a pooled analysis. Lancet 364, 1236–1243 (2004).
De Cock, K. M., Bunnell, R. & Mermin, J. Unfinished business--expanding HIV testing in developing countries. N. Engl. J. Med. 354, 440–442 (2006).
Fischer, A. et al. Simple DNA extraction method for dried blood spots and comparison of two PCR assays for diagnosis of vertical human immunodeficiency virus type 1 transmission in Rwanda. J. Clin. Microbiol. 42, 16–20 (2004).
Nesheim, S. et al. Quantitative RNA testing for diagnosis of HIV-infected infants. J. Acquir. Immune Defic. Syndr. 32, 192–195 (2003).
Rouet, F. et al. Early diagnosis of paediatric HIV-1 infection among African breast-fed children using a quantitative plasma HIV RNA assay. AIDS 15, 1849–1856 (2001).
Sherman, G. G., Stevens, G. & Stevens, W. S. Affordable diagnosis of human immunodeficiency virus infection in infants by p24 antigen detection. Pediatr. Infect. Dis. J. 23, 173–176 (2004).
Zijenah, L. S. et al. Signal-boosted qualitative ultrasensitive p24 antigen assay for diagnosis of subtype C HIV-1 infection in infants under the age of 2 years. J. Acquir. Immune Defic. Syndr. 39, 391–394 (2005).
Ginsburg, A. S., Miller, A. & Wilfert, C. M. Pediatric HIV diagnosis in resource-constrained settings. Pediatr. Infect. Dis. J. 25. 1057–1064 (2006).
Horwood, C., Liebeschuetz, S., Blaauw, D., Cassol, S. & Qazi, S. Diagnosis of paediatric HIV infection in a primary health care setting with a clinical algorithm. Bull. World Health Organ. 81, 858–866 (2003).
World Health Organization. Antiretroviral Therapy of HIV Infection in Infants and Children in Resource-Limited Settings: Towards Universal Access. Recommendations for a Public Health Approach (WHO, Geneva, 2006).
Gibb, D. & Kaganson, N. Cotrimoxazole prophylaxis in HIV: potential and problems. S. Afr. Resp. J. 8, 23–33 (2002).
World Health Organization. Guidelines on Co-Trimoxizole Prophylaxis for HIV-Related Infections among Children, Adolescents and Adults in Resource-Limited Settings: Recommendations for a Public Health Approach (WHO, Geneva, 2006).
Anglaret, X. et al. Early chemoprophylaxis with trimethoprim-sulphamethoxazole for HIV-1-infected adults in Abidjan, Cote d'Ivoire: a randomised trial. Cotrimo-CI Study Group. Lancet 353, 1463–1468 (1999).
Wiktor, S. Z. et al. Efficacy of trimethoprim-sulphamethoxazole prophylaxis to decrease morbidity and mortality in HIV-1-infected patients with tuberculosis in Abidjan, Cote d'Ivoire: a randomised controlled trial. Lancet 353, 1469–1475 (1999).
Yazdanpanah, Y. et al. Clinical impact and cost-effectiveness of co-trimoxazole prophylaxis in patients with HIV/AIDS in Cote d'Ivoire: a trial-based analysis. AIDS 19, 1299–1308 (2005).
The Joint United Nations Programme on HIV/AIDS. Report on the Global AIDS Epidemic (UNAIDS, Geneva, 2006).
Sherman, G. G., Matsebula, T. C. & Jones, S. A. Is early HIV testing of infants in poorly resourced prevention of mother to child transmission programmes unaffordable? Trop. Med. Int. Health 10, 1108–1113 (2005).
Girosi, F. et al. Developing and interpreting models to improve diagnostics in developing countries. Nature S1, 3–8 (2006).
Newell, M. L., Brahmbhatt, H. & Ghys, P. D. Child mortality and HIV infection in Africa: a review. AIDS 18 (suppl. 2), S27–S34 (2004).
Peckham, C. & Gibb, D. Mother-to-child transmission of the human immunodeficiency virus. N. Engl. J. Med. 333, 298–302 (1995).
Taha, T. E. et al. Morbidity among human immunodeficiency virus-1-infected and -uninfected African children. Pediatrics 106, E77 (2000).
Marston, M., Zaba, B., Salomon, J. A., Brahmbhatt, H. & Bagenda, D. Estimating the net effect of HIV on child mortality in African populations affected by generalized HIV epidemics. J. Acquir. Immune Defic. Syndr. 38, 219–227 (2005).
Chintu, C. et al. Co-trimoxazole as prophylaxis against opportunistic infections in HIV-infected Zambian children (CHAP): a double-blind randomised placebo-controlled trial. Lancet 364, 1865–1871 (2004).
Chokephaibulkit, K. et al. Pneumocystis carinii severe pneumonia among human immunodeficiency virus-infected children in Thailand: the effect of a primary prophylaxis strategy. Pediatr. Infect. Dis. J. 18, 147–152 (1999).
Duong, T., Ades, A. E., Gibb, D. M., Tookey, P. A. & Masters, J. Vertical transmission rates for HIV in the British Isles: estimates based on surveillance data. BMJ 319, 1227–1229 (1999).
The Joint United Nations Programme on HIV/AIDS and World Health Organization. AIDS Epidemic Update: December 2005 (WHO, Geneva, 2005).
United Nations Children's Fund. The State of the World's Children 2006: Excluded and Invisible (UNICEF, New York, 2005).
Manning, W., Fryback, D. & Weinstein, M. in Cost Effectiveness in Health and Medicine (eds Gold, M., Siegel, J., Russell, L. & Weinstein, M.) 247–275 (Oxford Univ. Press, New York, 1996).
Aledort, J. E., Rafael, M. E. & Shea, M. V. A Technical Report Reducing the Burden of HIV/AIDS in Infants: The Contribution of Improved Diagnostics WR-417-HLTH (RAND Corporation, Santa Monica 2006).
Sherman, G. G., Jones, S. A., Coovadia, A. H., Urban, M. F. & Bolton, K. D. PMTCT programme — partial assessments can build the picture. S. Afr. Med. J. 94, 934 (2004).
Zijenah, L. S. et al. T lymphocytes among HIV-infected and -uninfected infants: CD4/CD8 ratio as a potential tool in diagnosis of infection in infants under the age of 2 years. J. Transl. Med. 3, 6 (2005).
Fiscus, S.A.A. et al. HIV-1 viral load assess for resource-limited settings. PLOS Med. 3, 0001–0008 (2006).
Asamoah-Odei, E., Garcia Calleja, J. M. & Boerma, J. T. HIV prevalence and trends in sub-Saharan Africa: no decline and large subregional differences. Lancet 364, 35–40 (2004).
Mansergh, G. et al. Cost-effectiveness of short-course zidovudine to prevent perinatal HIV type 1 infection in a sub-Saharan African developing country setting. JAMA 276, 139–145 (1996).
Taha, T. E. et al. Association of HIV-1 load and CD4 lymphocyte count with mortality among untreated African children over one year of age. AIDS 14, 453–459 (2000).
United Nations Children's Fund. Call to Action: Children — The Missing Face of AIDS (UNICEF, New York, 2005).
Murray, C. & Lopez, A. (eds.) The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020 (Harvard Univ. Press on behalf of the WHO and the World Bank, Cambridge, 1996).
Acknowledgements
The authors thank T. Denny (UMDNJ–New Jersey Medical School, New Jersey, USA), S. A. Bozzette (RAND Corporation, California, USA), M. Urdea (Halteres Associates LLC, California, USA), P. Musoke (Makerere University, Kampala, Uganda), T. M. Meyers (Chris Hani Baragwanath Hospital, Soweto, South Africa) and D. M. Gibb (Medical Research Council Clinical Trials Unit, London, UK).
Author information
Authors and Affiliations
Corresponding author
Additional information
This article has not been written or reviewed by the Nature editorial team and Nature takes no responsibility for the accuracy or otherwise of the information provided.
Rights and permissions
About this article
Cite this article
Aledort, J., Ronald, A., Le Blancq, S. et al. Reducing the burden of HIV/AIDS in infants: the contribution of improved diagnostics. Nature 444 (Suppl 1), 19–28 (2006). https://doi.org/10.1038/nature05443
Published:
Issue Date:
DOI: https://doi.org/10.1038/nature05443
This article is cited by
Comments
By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.