ART initiation

'Good health' as a barrier and facilitator to ART initiation: a qualitative study in the era of test-and-treat in Mozambique

HIV test-and-treat programmes are being implemented throughout sub-Saharan Africa, enrolling HIV-positive clients into antiretroviral treatment (ART) immediately after diagnosis, regardless of clinical stage or CD4 count. This study conducted in Mozambique examined what influenced clients who tested HIV-positive in the context of test-and-treat to make ART initiation decisions.
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Innovations and challenges in early infant diagnosis of HIV

This article aims at examining the key recent advances in the field of EID, as well as at discussing approaches for resolving the major bottlenecks faced by health systems in the identification and linkage to care of HIV-infected infants.
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Retention in Care Trajectories of HIV-Positive Individuals Participating in a Universal Test-and-Treat Program in Rural South Africa (ANRS 12249 TasP Trial)

Author
Gosset, Andréa; Protopopescu, Camelia; Larmarange, Joseph; Orne-Gliemann, Joanna; McGrath, Nuala; Pillay, Deenan,; Dabis, François; Iwuji, Collins; Boyer, Sylvie
In this study, we aimed to study retention in care trajectories and associated factors in ART-eligible patients enrolled in a universal test-and-treat trial implemented in rural South Africa.
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12-month outcomes of HIV-infected infants identified at birth at one maternity site in Johannesburg, South Africa: an observational cohort study

Author
Karl-Günter Technau, Renate Strehlau, Faeezah Patel, Stephanie Shiau, Megan Burke, Martie Conradie, Gillian Sorour, Gayle G Sherman, Ashraf Coovadia, Pamela M Murnane, Elaine J Abrams, Louise Kuhn
Initiation of antiretroviral therapy (ART) following diagnosis of HIV infection at birth is an emerging area of paediatric HIV care. We present outcomes of HIV-infected infants identified at birth at Rahima Moosa Mother and Child Hospital in Johannesburg, South Africa.
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Xpert HIV-1 point-of-care test for neonatal diagnosis of HIV in the birth testing programme of a maternity hospital: a field evaluation study

Author
Technau KG, Kuhn L, Coovadia A, Murnane PM, Sherman G

Background

Point-of-care testing (POCT) among HIV-exposed infants might improve linkage to care relative to laboratory-based testing (LABT). We evaluated HIV-1 POCT at birth in the context of universal LABT in a maternity hospital and describe our implementation experience.

Methods

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Recording and Q&A session: Improving early infant diagnosis webinar

Is the resource available on the Internet?
Yes
Author
The Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree) Project

An essential first step in caring for HIV-infected children is accurate and early diagnosis of HIV, early HIV testing, prompt return of results, and rapid initiation of treatment. Survival of HIV‐infected infants depends on a robust early infant diagnosis (EID) system that allows for tracking of infants through to their final HIV status. HIV-infected, untreated infants have rapid disease progression and high mortality—half of HIV‐infected infants will die by age 2 without treatment.

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Which HIV-infected adults with high CD4 T-cell counts benefit most from immediate initiation of antiretroviral therapy? A post-hoc subgroup analysis of the START trial

Is the resource available on the Internet?
Yes
Author
Jean-Michel Molina, Birgit Grund, Fred Gordin et al.

Background

Immediate initiation of antiretroviral therapy (ART) in asymptomatic adults with CD4 counts higher than 500 cells per μL, as recommended, might not always be possible in resource-limited settings. We aimed to identify subgroups of individuals who would benefit most from immediate treatment.

Methods

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Webinar: Improving Early Infant Diagnosis

Venue
Webinar

An essential first step in caring for HIV-infected children is accurate and early diagnosis of HIV, early HIV testing, prompt return of results, and rapid initiation of treatment. Survival of HIV‐infected infants depends on a robust early infant diagnosis (EID) system that allows for tracking of infants through to their final HIV status. HIV-infected, untreated infants have rapid disease progression and high mortality—half of HIV‐infected infants will die by age 2 without treatment.

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Misdiagnosed HIV infection in pregnant women initiating universal ART in South Africa

Is the resource available on the Internet?
Yes
Author
Nei-yuan Hsiao, Allison Zerbe, Tamsin K. Phillips, Landon Myer, Elaine J. Abrams

Rapid diagnostic tests (RDTs) are the primary diagnostic tools for HIV used in resource-constrained settings. Without a proper confirmation algorithm, there is concern that false-positive (FP) RDTs could result in misdiagnosis of HIV infection and inappropriate antiretroviral treatment (ART) initiation, but programmatic data on FP are few.

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Identification of misdiagnosed HIV clients in an Early Access to ART for All implementation study in Eswatini

Is the resource available on the Internet?
Yes
Author
Shaukat Khan, Emma Mafara, Munyaradzi Pasipamire, Donna Spiegelman, Sikhathele Mazibuko, Nombuso Ntshalintshali, Anita Hettema, Charlotte Lejeune, Fiona Walsh, Velephi Okello

Rapid diagnostic testing has made HIV diagnosis and subsequent treatment more accessible. However, multiple factors, including improper implementation of testing strategies and clerical errors, have been reported to lead to HIV misdiagnosis. The World Health Organization has recommended HIV retesting prior to antiretroviral therapy (ART) initiation which has become pertinent with scaling up of Early Access to ART for All (EAAA). In this analysis, misdiagnosed clients are identified from a subgroup of clients enrolled in EAAA implementation study in Swaziland.

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