Delays in HIV-1 infant PCR testing may leave children without confirmed diagnoses
Date
2021-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
Background
The early diagnosis and confirmation of HIV infection in newborns is crucial for expedited
antiretroviral therapy initiation. Confirmatory testing must be done for all children with a
reactive HIV PCR result. There is no comprehensive data on confirmatory testing and
rejection of HIV PCR test requests at National Health Laboratory Service laboratories.
Aim and objectives
To assess relevant measures for routine infant HIV PCR testing: rate of rejected test
requests, turnaround time, and rate of confirmatory testing.
Method
A retrospective review was performed on the laboratory-based data of all HIV PCR tests
that were performed on children ≤24 months old (n=43,346), and data of rejected HIV PCR
requests (n=1,479) over a two-year period (2017-2019). These data were extracted from the
laboratory information system. Data were analyzed from sample collection to release of
results, assessing the TAT and follow-up patterns.
Results
The proportion of HIV PCR requests that were rejected was 3.3%, of which 83.9% were
rejected for various pre-analytical reasons. The majority of test results (89.2%) met the
required 96-hour TAT. Of the reactive initial test results, 53.5% had a follow-up sample
sent, of which 93.1% were positive on follow-up. Of the initial indeterminate results, 74.7%
were negative on follow-up.
Conclusion
A significant proportion of HIV PCR requests were rejected for various pre-analytical
reasons. The high number of initial reactive tests, without evidence of follow-up, may
suggest that a shorter TAT would be required to allow confirmatory testing, before children
are discharged.
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar
AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar
Description
Thesis (MMed)--Stellenbosch University, 2021.
Keywords
HIV -- Infant -- Diagnosis, UCTD, HIV-positive children, Antiretroviral drugs, Diagnosis, Laboratory, Polymerase chain reaction -- Diagnostic use