early infant diagnosis (EID)

Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: Interim guidance

Author
WHO

Update on recommendations on antiretroviral regimens for treating and preventing HIV infection: In 2016, WHO published the consolidated guidelines on the use of antiretroviral (ARV) drugs for treating and preventing HIV infection and recommended tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) (or emtricitabine, FTC) + efavirenz (EFV) 600 mg as the preferred first-line antiretroviral therapy (ART) regimen for adults and adolescents.

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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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Updated recommendations on first-line and second-line antiretroviral regimens and post-exposure prophylaxis and recommendations on early infant diagnosis of HIV: interim guidance

Author
World Health Organization
Since 2016, WHO has recommended tenofovir disoproxil fumarate (TDF) + lamivudine (3TC) (or emtricitabine, FTC) + efavirenz (EFV) 600 mg as the preferred first- line antiretroviral therapy (ART) regimen for adults and adolescents. WHO recommended dolutegravir (DTG) as an alternative option to EFV for first-line ART because of the uncertainty regarding the safety and efficacy of DTG during pregnancy and among people living with HIV receiving rifampicin-based tuberculosis (TB) treatment. New WHO interim guidelines contain recommendations regarding preferred first-line regimens for adults, adolescents and children initiating ART, which now include DTG and RAL.
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Leaving no child behind: best practices and lessons learned from the ACT initiative

Bright and early Wednesday morning, nine speakers and more than 70 participants from international development organizations, donor agencies, and academia gathered at AIDS 2018 to discuss best practices and lessons learned from The Accelerating Children’s HIV/AIDS Treatment (ACT), reflecting how we can sustain and continue to accelerate progress in reaching children and adolescents living with HIV. Participants asked thoughtful questions and engaged in lively discussion with the panel of speakers, including reflection on challenges with case identification and the need for countries to strategically position point of care diagnostics.
Author
Johanna Theunissen, Communications Officer, Baylor College of Medicine Children’s Foundation/SHARE staff

JAIDS supplement: Post-program learning and knowledge from the Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative

Baylor-Malawi, with USAID funding, has developed a special JAIDS supplement featuring 11 articles which highlight lessons and best practices from the Accelerating Children’s HIV/AIDS Treatment (ACT) Initiative, a public-private partnership that expanded pediatric HIV services in nine sub-Saharan African countries from 2014-2016, providing treatment to more than 560,000 children living with HIV.

Articles include:

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Policy brief: update on antiretroviral regimens for treating and preventing HIV infection and update on early infant diagnosis of HIV: interim guidance

Author
World Health Organization

Since WHO published the 2016 ARV guidelines, several studies have evaluated the safety and efficacy of dolutegravir (DTG) during pregnancy and the periconception period, among children and among people with HIV-associated TB infection. Ample evidence supports using DTG as a preferred first-line ARV drug for everyone living with HIV older than six years and weighing more than 15 kg, including women and adolescent girls of childbearing potential who are u

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Prevalence and outcomes of HIV-1 diagnostic challenges during universal birth testing - an urban South African observational cohort

Author
Technau KG, Mazanderani AH, Kuhn L, Hans L, Strehlau R, Abrams EJ, Conradie M, Coovadia A, Mbete N, Murnane PM, Patel F, Shiau S, Tiemessen CT, Sherman GG

INTRODUCTION:

HIV-1 polymerase chain reaction (PCR) testing at birth aims to facilitate earlier initiation of antiretroviral therapy (ART) for HIV-infected neonates. Data from two years of universal birth testing implementation in a high-burden South African urban setting are presented to demonstrate the prevalence and outcomes of diagnostic challenges in this context.

METHODS:

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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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Improving early identification of HIV-infected neonates with birth PCR testing in a large urban hospital in Johannesburg, South Africa: successes and challenges

Author
Technau KG, Kuhn L, Coovadia A, Carmona S, Sherman G

INTRODUCTION:

Timely diagnosis is necessary to avert early death in HIV-infected neonates. Birth PCR testing may improve early identification and facilitate access to care. We implemented a birth HIV diagnosis programme in Johannesburg, South Africa and present successes and challenges of the first two and a half years of operation.

METHODS:

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Piloting very early infant diagnosis of HIV in Lesotho: Acceptability and feasibility among mothers, health workers and laboratory personnel

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Yes
Author
Michelle M. Gill, Lynne M. Mofenson, Mamakhetha Phalatse, Vincent Tukei, Laura Guay, Matsepeli Nchephe

Mortality associated with in-utero HIV infection rises rapidly within weeks after birth. Very early infant diagnosis of HIV (VEID)–testing within 2 weeks of birth–followed by immediate initiation of antiretroviral therapy has potential to avert mortality associated with in-utero transmission. However, our understanding of acceptability and feasibility of VEID is limited.

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