Infants in Kenya can now be diagnosed for HIV, at birth. This is after World Health Organisation (WHO) issued the greenlight for use of Alere q HIV-1/2 Detect assay, a diagnostic tool that provides results within 52 minutes.
Currently, newborns in Kenya are screened for HIV infection with dry blood spot testing, the widely available testing used for adults.
The challenge with this is that health workers have to wait between three and six weeks for tests to be done, a window that medics say many potentially HIV-positive infants are lost to follow-up and go untreated.
Tests can take as long as four months to be available for the baby to start antiretroviral therapy (ART), this style of testing cannot therefore, be reliably used for confirmatory diagnosis of HIV in infants.
Babies born to HIV-positive mothers have the mother’s protective antibodies (which can persist for 18 months) in their blood, and current diagnostic methods are not able to discriminate between a mother’s and an infant’s antibodies to detect if a newborn is infected with HIV.
However, with Alere q HIV-1/2 Detect it is possible to identify and differentiate between HIV-1 and HIV-2 with as small a sample as 25 micro-liters of whole blood or plasma.
The kit is easy to carry and portable and can be battery-powered.
According to Dr Ahmed Kalebi, CEO of Lancet Kenya Labs, molecular diagnostic machines are currently available at top tier health facilities and laboratories but are relatively expensive and can only run tests in batches.
“These machines require between 10 and 30 samples. A sample cannot be tested alone. Therefore, for test results to be available, all samples must be in for the machine to operate,” Dr Ahmed says.
He continues: “Alere q is the first machine of its kind in Kenya. The test is done per patient and it is therefore immediate. This makes diagnosis of infant HIV quite simple and test results can be picked on the go. It reduces turn-around time and therefore makes it easy to start an infected newborn on antiretroviral treatment immediately.”
Alere q HIV-1/2 Detect could have a significant impact in Kenya, where an estimated 37,000 to 42,000 infants are infected with HIV each year due to mother-to-child transmission.
Early antiretroviral therapy significantly increases the likelihood majority of children born to HIV-infected mothers will be uninfected – with effective ARV/ART interventions exceeding 90 per cent, according to WHO.
Dr Martin Sirengo, Director - National Aids and STIs Control Programme, has called for enacting of Alere q HIV-1/2 Detect into Kenya’s health system, saying: “Molecular EID can be implemented as part of national guidelines, health workers have a powerful tool to help meet WHO goals for timely viral HIV screening of newborns.”
The WHO recommends that all HIV-exposed infants have HIV viral load testing at four to six weeks of age or at the earliest opportunity thereafter, and that ART be initiated in infants diagnosed with HIV.
Statistics by WHO show that most infants, who are HIV-infected, die under the age of two years and about 33 per cent die under the age of one year.