Early infant diagnosis (EID): A vital component of prevention of parent to child transmission program

Abstract

Background: Early diagnosis of HIV infection in exposed infants and children is essential component to child survival. EID, a virological DNA PCR test on dried blood spot, aims at early diagnosis and ART initiation, breast feeding choices and linkage to care. It confers substantial benefit to the infected and uninfected infants and provides a unique opportunity to evaluate the performance of PPTCT program. Materials and method: Present study conducted in the department of Obstetrics and Gynecology, NSCB Medical College, Jabalpur from March 2016 to August 2017. HIV exposed infants and children between 6 weeks to 18 months of age were included. HIV testing (DNA PCR and antibody tests) done at 6weeks, 6, 12 and 18 months as per pediatric ART guidelines of NACO, 2015. Results: Total 145 infants/children were tested during study period. 8 found to be HIV positive which gives an incidence of 5.51% in out institute.112 (80.7%) had first visit between 6 weeks to 6 months.130(89.6)% mother-baby pair received ART/ARV prophylaxis. Transmission rate lowest (0.76%) in Mother-baby pair who received ART. 69(47.9% infants were on replacement feeding. The transmission rate was (8.1%). One death observed and 12 (8.27%) lost to follow up. EID results at first contact were accurate and well correlated with the results at 6, 12 and 18 month. Conclusion: EID is a vital component of PPTCT program. It confirms the diagnosis as early as 6 weeks and confers an accurate and consistent results throughout testing protocol, thus establishing the integrity of EID. It assists in decision making on infant feeding practices.