Early infant diagnosis of HIV infection in southeastern Nigeria: prevalence of HIV infection among HIV-exposed babies.
BACKGROUND
Vertical transmission of HIV-1 is responsible for a high level of infant mortality necessitating early infant diagnosis. Serologic tests are not useful because of persistence of maternal antibodies in infants. Amplification of the integrated viral genome by PCR is the preferred method of diagnosis of HIV infection in these children.


OBJECTIVE
To determine the prevalence of HIV among a cohort of HIV-exposed babies.


METHODS
HIV-exposed infants were recruited for DNA PCR (early infant diagnosis). Babies were enrolled from six weeks of age. Relevant data were collected with the aid of a proforma. Mothers were given pre-test counselling. Heel or finger prick samples of blood on Whatman filter paper were used for DNA PCR testing.


RESULTS
Data on the initial 304 babies enrolled for DNA PCR were analyzed. Seven (3.6%) of 192 mother-baby pairs who had received requisite prophylactic anti-retrovirals (PARV) were PCR-positive. In 23 (8.7%) PCR positive babies, their mothers received PARV but the babies had no post exposure prophylaxis (PEP), while two (12.5%) of 16 babies who had received PARV without their mothers turned out PCR-positive. Thirty nine (53.4%) of 73 mother-baby pairs who had no PARV were infected. Exclusive breastfeeding (EBF) rate was 35.5%. In these babies five (18.5%) were infected, while 288 (75%) of babies were exclusive formula fed (EFF), out of which 11 (4.8%) were infected. Forty-seven (15.5%) of the babies were mixed-fed, and 32 (68.0%) of them were infected.


CONCLUSIONS
Prophylactic ARV in mothers and babies gave a marked reduction in Mother-to-Child-Transmission (MTCT) rate. Feeding BMS conferred a superior protection against (MTCT) than EBF.
Ugochukwu
E F
EF
Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. efugochukwu@yahoo.co.uk
Kanu
S O
SO
D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D021141:Nucleic Acid Amplification Techniques; D016133:Polymerase Chain Reaction; D015995:Prevalence