Page 341 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 3 of 5 Original Research

pregnancies (mothers < 18 years old) and 43 (10.1%) 3 (1.9%) tested positive, 151 (96.2%) tested negative and 3
pregnancies in mothers aged 35 years and older. Nearly (1.9%) had an insufficient specimen for a result. The median
half the mothers had been pregnant at least twice before number of days for the 10-week PCR testing was 73 days, and
(parity ≥ 2, 48.5%; gravidity ≥ 3, 45.5%). The ART details were the mode was 70 days.
recorded for only 410 of the mothers of which 361 (88.0%)
mothers were on ART. Of the 375 babies who had a birth PCR, 57.3% (n = 215) had a
follow-up test at any date.
Figure 1 is a schematic representation of the HIV-exposed
infants and their PCR testing and outcomes at birth and 10 Twenty mothers or caregivers returned with their infants for
weeks. follow-up testing before the 10-week time frame (i.e. ≤ 55
days after the birth HIV PCR test). The median number of
The majority of HIV-exposed infants (87.6%) received an days was 42 days (range: 7–46 days). Eighteen infants tested
HIV-1 PCR test at birth, of whom 87.2% tested HIV-negative. negative, and two infants had an insufficient specimen. Two
When looking at month-specific percentages, during infants were tested before 10 weeks and again at 10 weeks.
November, only 47.9% (23/48) of HIV-exposed infants One infant tested negative on both occasions. The second
received birth PCR tests. Instead, a viral load test was infant had an insufficient specimen before 10 weeks and
performed on the mother. There was no outcome recorded tested negative at 10 weeks.
for 11.7% of all infants tested at birth, because of either
insufficient specimen or missing results. Of the 22 infants Fifty infants were tested only after 3 months (i.e. 90 or more
born in July, 16 (72.7%) had an insufficient specimen. This is days after the birth HIV PCR test).The median number of days
48.5% of the total of 33 insufficient specimens at birth. Of was 119 days (range: 90–441 days). The PCR outcome for 49 of
these 33 infants, only a third were retested at 10 weeks. the infants was negative, and one infant had an insufficient
specimen. Four infants were tested before 10 weeks and again
Of the 34 babies born to teenage mothers, 82.4% had an HIV-1 after 3 months. All four infants tested negative at both dates.
PCR test at birth. The birth PCR results were conclusive in 24
babies of whom 2 (7.7%) tested positive. Of the 43 infants born Nevirapine was given to 427 (99.8%) infants with one file
to mothers aged 35 and older, 90.7% had an HIV-1 PCR test at having no record of this.
birth, but none of these babies had a positive birth PCR test.
Discussion
Of the infants who tested HIV-negative at birth, 44.3% had a
repeat PCR at 10 weeks, of whom 1.4% tested HIV-positive. A third (33.3%) of the mothers who gave birth at MUCPP
Irrespective of the HIV PCR test outcome at birth (positive, CHC during 2016 were HIV-positive. Among these HIV-
negative or insufficient specimen), 43.1% of the infants positive mothers, there were 7.3% teenage pregnancies and
(157/364) returned for a 10-week follow-up visit of whom 10.1% pregnancies to women over the age of 35 years, also

Number of babies n = 428

Yes No
Birth PCR test performed n = 375 n = 53
(87.6%) (12.4%)

Nega ve Posi ve Insufficient Missing*
Birth PCR test outcome n = 327 n = 4 specimen n = 11
(87.2%) (1.1%) n = 33 (8.8%) (2.9%)

Yes No Yes No Yes No
10-week PCR test perfomed n = 145 n = 182 n = 1 n = 3 n = 11 n = 22
(44.3%) (55.7%) (25.0%) (75.0%) (33.3%) (66.7%)

Posi ve Nega ve Insufficient Posi ve Nega ve Posi ve Nega ve
10-week PCR test outcome n = 2 n = 140 specimen n = 1 n = 0 n = 0 n = 11
(1.4%) (96.6%) n = 3 (2.1%) (100%) (0%) (0%) (100%)

PCR, polymerase chain reaction.
FIGURE 1: Birth and 10-week polymerase chain reaction testing of HIV-exposed infants.

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