title: [Early diagnosis of human immunodeficiency virus-1 in infants: The prevention of mother-to-child transmission program in Equatorial Guinea].
abstract: BACKGROUND
  Great efforts have been made in the last few years in order to implement the prevention of mother-to-child transmission (PMTCT) program in Equatorial Guinea (GQ). The aim of this study was to evaluate the rates of mother-to-child HIV transmission based on an HIV early infant diagnosis (EID) program.
  
  
  METHODS
  A prospective observational study was performed in the Regional Hospital of Bata and Primary Health Care Centre Maria Rafols, Bata, GQ. Epidemiological, clinical, and microbiological characteristics of HIV-1-infected mothers and their exposed infants were recorded. Dried blood spots (DBS) for HIV-1 EID were collected from November 2012 to December 2013. HIV-1 genome was detected using Siemens VERSANT HIV-1 RNA 1.0 kPCR assay.
  
  
  RESULTS
  Sixty nine pairs of women and infants were included. Sixty women (88.2%) had WHO clinical stage 1. Forty seven women (69.2%) were on antiretroviral treatment during pregnancy. Forty five infants (66.1%) received postnatal antiretroviral prophylaxis. Age at first DBS analysis was 2.4 months (IQR 1.2-4.9). One infant died before a HIV-1 diagnosis could be ruled out. Two infants were HIV-1 infected and started HAART before any symptoms were observed. The rate of HIV-1 transmission observed was 2.9% (95%CI 0.2-10.5).
  
  
  CONCLUSIONS
  The PMTCT rate was evaluated for the first time in GQ based on EID. EID is the key for early initiation of antiretroviral therapy and to reduce the mortality associated with HIV infection.
authors.affiliation: Servicio de Pediatría, Hospital Universitario de Getafe, Getafe, Madrid, España. Electronic address: lmprieto.hugf@salud.madrid.org.
authors.forename: Luis Manuel
authors.initials: LM
authors.lastname: Prieto-Tato
authors.affiliation: Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, RICET, Madrid, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vargas
authors.affiliation: Laboratorio de Epidemiología Molecular VIH-1, Departamento de Microbiología y Parasitología, Hospital Universitario Ramón y Cajal, IRYCIS y CIBERESP, Madrid, España.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Álvarez
authors.affiliation: Departamento de Enfermedades Infecciosas e Inmunodeficiencias, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: Pedro
authors.initials: P
authors.lastname: Avedillo
authors.affiliation: Servicio de Análisis Clínicos, Hospital Regional de Bata Dr. Damian Roku, Bata, Guinea Ecuatorial.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Nzi
authors.affiliation: Departamento de Enfermedades Infecciosas e Inmunodeficiencias, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: Carlota
authors.initials: C
authors.lastname: Abad
authors.affiliation: Servicio de Pediatría, Hospital Universitario de Getafe, Getafe, Madrid, España.
authors.forename: Sara
authors.initials: S
authors.lastname: Guillén
authors.affiliation: Laboratorio de Epidemiología Molecular VIH-1, Departamento de Microbiología y Parasitología, Hospital Universitario Ramón y Cajal, IRYCIS y CIBERESP, Madrid, España.
authors.forename: Carolina
authors.initials: C
authors.lastname: Fernández-McPhee
authors.affiliation: Servicio de Pediatría, Hospital Universitario Clínico San Carlos, Madrid, España.
authors.forename: José Tomás
authors.initials: JT
authors.lastname: Ramos
authors.affiliation: Laboratorio de Epidemiología Molecular VIH-1, Departamento de Microbiología y Parasitología, Hospital Universitario Ramón y Cajal, IRYCIS y CIBERESP, Madrid, España.
authors.forename: África
authors.initials: Á
authors.lastname: Holguín
authors.affiliation: Departamento de Enfermedades Infecciosas e Inmunodeficiencias, Servicio de Pediatría, Hospital Universitario 12 de Octubre, Madrid, España.
authors.forename: Pablo
authors.initials: P
authors.lastname: Rojo
authors.affiliation: Servicio de Pediatría, Hospital Regional de Bata Dr. Damian Roku, Bata, Guinea Ecuatorial.
authors.forename: Jacinta
authors.initials: J
authors.lastname: Obiang
mesh_terms: D000328:Adult; D042241:Early Diagnosis; D016703:Equatorial Guinea; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies
keywords: Diagnóstico precoz; Dried blood spots; Early infant diagnosis; Gota de sangre seca; Human immunodeficiency virus; Prevención de la transmisión maternoinfantil; Prevention of mother-to-child transmission; Virus de la inmunodeficiencia humana