Delays in HIV-1 infant PCR testing may leave children without confirmed diagnoses

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dc.contributor.advisorVan Zyl, Gerten_ZA
dc.contributor.advisorPreiser, Wolfgangen_ZA
dc.contributor.authorMahlakwane, Kamela L.en_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology: Medical Virology.en_ZA
dc.date.accessioned2021-07-13T09:25:08Z
dc.date.accessioned2021-12-22T14:14:33Z
dc.date.available2021-07-13T09:25:08Z
dc.date.available2021-12-22T14:14:33Z
dc.date.issued2021-12
dc.descriptionThesis (MMed)--Stellenbosch University, 2021.en_ZA
dc.description.abstractBackground 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.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Geen opsomming beskikbaaraf_ZA
dc.description.versionMastersen_ZA
dc.format.extent34 pagesen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/123660
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch Universityen_ZA
dc.rights.holderStellenbosch Universityen_ZA
dc.subjectHIV -- Infant -- Diagnosisen_ZA
dc.subjectUCTDen_ZA
dc.subjectHIV-positive childrenen_ZA
dc.subjectAntiretroviral drugsen_ZA
dc.subjectDiagnosis, Laboratoryen_ZA
dc.subjectPolymerase chain reaction -- Diagnostic useen_ZA
dc.titleDelays in HIV-1 infant PCR testing may leave children without confirmed diagnosesen_ZA
dc.typeThesisen_ZA
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