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Rivero-Arias O, Png ME, White A, Yang M, Taylor-Phillips S, Hinton L, Boardman F, McNiven A, Fisher J, Thilaganathan B, Oddie S, Slowther AM, Ratushnyak S, Roberts N, Shilton Osborne J, Petrou S. Benefits and harms of antenatal and newborn screening programmes in health economic assessments: the VALENTIA systematic review and qualitative investigation. Health Technol Assess 2024; 28:1-180. [PMID: 38938110 PMCID: PMC11228689 DOI: 10.3310/pytk6591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024] Open
Abstract
Background Health economic assessments are used to determine whether the resources needed to generate net benefit from an antenatal or newborn screening programme, driven by multiple benefits and harms, are justifiable. It is not known what benefits and harms have been adopted by economic evaluations assessing these programmes and whether they omit benefits and harms considered important to relevant stakeholders. Objectives (1) To identify the benefits and harms adopted by health economic assessments in this area, and to assess how they have been measured and valued; (2) to identify attributes or relevance to stakeholders that ought to be considered in future economic assessments; and (3) to make recommendations about the benefits and harms that should be considered by these studies. Design Mixed methods combining systematic review and qualitative work. Systematic review methods We searched the published and grey literature from January 2000 to January 2021 using all major electronic databases. Economic evaluations of an antenatal or newborn screening programme in one or more Organisation for Economic Co-operation and Development countries were considered eligible. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. We identified benefits and harms using an integrative descriptive analysis and constructed a thematic framework. Qualitative methods We conducted a meta-ethnography of the existing literature on newborn screening experiences, a secondary analysis of existing individual interviews related to antenatal or newborn screening or living with screened-for conditions, and a thematic analysis of primary data collected with stakeholders about their experiences with screening. Results The literature searches identified 52,244 articles and reports, and 336 unique studies were included. Thematic framework resulted in seven themes: (1) diagnosis of screened for condition, (2) life-years and health status adjustments, (3) treatment, (4) long-term costs, (5) overdiagnosis, (6) pregnancy loss and (7) spillover effects on family members. Diagnosis of screened-for condition (115, 47.5%), life-years and health status adjustments (90, 37.2%) and treatment (88, 36.4%) accounted for most of the benefits and harms evaluating antenatal screening. The same themes accounted for most of the benefits and harms included in studies assessing newborn screening. Long-term costs, overdiagnosis and spillover effects tended to be ignored. The wide-reaching family implications of screening were considered important to stakeholders. We observed good overlap between the thematic framework and the qualitative evidence. Limitations Dual data extraction within the systematic literature review was not feasible due to the large number of studies included. It was difficult to recruit healthcare professionals in the stakeholder's interviews. Conclusions There is no consistency in the selection of benefits and harms used in health economic assessments in this area, suggesting that additional methods guidance is needed. Our proposed thematic framework can be used to guide the development of future health economic assessments evaluating antenatal and newborn screening programmes. Study registration This study is registered as PROSPERO CRD42020165236. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: NIHR127489) and is published in full in Health Technology Assessment; Vol. 28, No. 25. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - May Ee Png
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ashley White
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Miaoqing Yang
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Lisa Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- THIS Institute, University of Cambridge, Cambridge, UK
| | | | - Abigail McNiven
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | - Sam Oddie
- Bradford Institute for Health Research, Bradford Children's Research, Bradford, UK
| | | | - Svetlana Ratushnyak
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Jenny Shilton Osborne
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Bert F, Gualano MR, Biancone P, Brescia V, Camussi E, Martorana M, Thomas R, Secinaro S, Siliquini R. HIV screening in pregnant women: A systematic review of cost-effectiveness studies. Int J Health Plann Manage 2017; 33:31-50. [PMID: 28556453 DOI: 10.1002/hpm.2418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/12/2017] [Accepted: 04/12/2017] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Vertical transmission represents the major route of HIV infection for children. However, the preventive interventions available are extremely effective. This review summarizes evidence regarding the cost-effectiveness of mother-to-child-transmission preventive screenings, to help policy makers in choosing the optimal antenatal screening strategy. METHODS A systematic review following PRISMA guidelines was conducted, using 3 databases: PubMed, Scopus, and Cost-Effectiveness Analysis Registry. All articles regarding HIV screening to avoid vertical transmission were included. RESULTS The review included 21 papers. Seven studies assessed the cost-effectiveness of universal antenatal screening during early gestation. Two papers considered the integration of HIV screening with other medical interventions. Eight works estimated the cost-effectiveness of HIV screening in late pregnancy. Finally, 4 papers considered the combination of multiple strategies. The selected papers focused on both developed and developing countries, with a different HIV prevalence. The characteristics and methodology of the studies were heterogeneous. However, all studies agreed about the main findings, outlining the cost-effectiveness of both universal antenatal screening and HIV rescreening in late pregnancy. Cost-effectiveness improved when HIV burden increased. The major findings were proved to be robust across various scenarios when tested in sensitivity analysis. CONCLUSIONS The review confirmed the cost-effectiveness not only of HIV universal antenatal screening but also of rescreening in late gestation in both developed and developing countries. Universal screening is cost-effective even in case of extremely low HIV prevalence. Therefore, to maximize screening, coverage appears as a worldwide priority. In certain settings, a targeted screening towards high-risk groups could be a valuable option.
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Affiliation(s)
- Fabrizio Bert
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | | | - Paolo Biancone
- Department of Management, University of Turin, Turin, Italy
| | | | - Elisa Camussi
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Maria Martorana
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | - Robin Thomas
- Department of Public Health Sciences, University of Turin, Turin, Italy
| | | | - Roberta Siliquini
- Department of Public Health Sciences, University of Turin, Turin, Italy
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Nyoyoko NP, Umoh AV. The prevalence and determinants of HIV seroconversion among booked ante natal clients in the University of Uyo teaching hospital, Uyo Akwa Ibom State, Nigeria. Pan Afr Med J 2016; 25:247. [PMID: 28293363 PMCID: PMC5337286 DOI: 10.11604/pamj.2016.25.247.6715] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 12/05/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The Prevention of Mother to Child transmission (PMTCT) of HIV, an important intervention in the fight against HIV/AIDS can only be of benefit if the HIV status of the mother is known. Unfortunately, some women receive HIV counseling and testing (HCT) during the window period or prior to new infection in pregnancy and therefore, miss-out on the gains of PMTCT. A repeat HIV test would identify this later seroconversion and ensure early intervention. This study aimed at determining the prevalence of HIV seroconversion during pregnancy and assessing the factors associated with HIV seroconversion in clients who attended ante-natal clinic (ANC) in University of Uyo Teaching Hospital, Uyo. METHODS A descriptive cross-sectional design was used to study 502 HIV negative clients who consecutively presented for ANC in the University of Uyo Teaching Hospital Uyo over a 3 months period (July -September 2013). RESULTS Fifteen (3%) of the 502 women who were HIV negative at booking visit tested positive (seroconverted) to HIV. Determinants of seroconversion at multivariate level were age bracket of 25-29 years (OR: 3.20; 95%CI: 2.39-4.29) clients' partners who had sexually transmitted infections, as evidenced by penile discharge (OR: 0.09; 95%CI: 0.01-0.45); Clients in polygamous setting (OR: 3.98; CI: 1.64-9.65); those taking alcohol (OR: 0.12; CI: 0.20-0.80) and those with partners taking recreational drugs (OR: 0.05, 95%CI: 0.002-0.995). CONCLUSION The study revealed a high seroconversion rate. Re-screening of pregnant women after the booking HCT is a very cost effective and beneficial strategy for the elimination of mother to child transmission of HIV.
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Affiliation(s)
- Nsikak Paul Nyoyoko
- Department of Obstetrics and Gynaecology, University of Uyo Teaching Hospital, Uyo, Nigeria
| | - Augustine Vincent Umoh
- Department of Obstetrics and Gynaecology, University of Uyo Teaching Hospital, Uyo, Nigeria
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Nguefack F, Dongmo R, Touffic Othman CL, Tatah S, Njiki Kinkela MN, Koki Ndombo PO. Obstetrical, maternal characteristics and outcome of HIV-infected rapid progressor infants at Yaounde: a retrospective study. Transl Pediatr 2016; 5:46-54. [PMID: 27186521 PMCID: PMC4855195 DOI: 10.21037/tp.2016.04.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Rapid progressors are exposed to HIV infection at an early stage of life, and the prognosis is poor without treatment. Reducing the proportion of infants who are rapid progressors, require strengthening strategies to achieve the highest level of performance for the PMTCT program. METHODS This was a retrospective study carried out on HIV infected infants aged less than 12 months, clinically classified stage 4 (WHO) or having CD4 count <25%. We described maternal and obstetrical characteristics of HIV-infected rapid progressors using univariate and bivariate analysis. Patients' survival was monitored from the inclusion time to the end of the study. We then estimated their probability of survival with or without anti-retroviral (ARV) treatment from birth using the Kaplan-Meier method. RESULTS The characteristics of the mothers of the 150 rapid progressors infants we included were: low level of education (OR=3.87; P=0.016), CD4 count less than 200/mm(3) (OR=43.3; P=0.000), absence of ARV prophylaxis (OR=6.02; P=0.043), or treatment with HAART (OR=5.74; P=0.000) during pregnancy. In the children, the most important findings were lack of co-trimoxazole prophylaxis (OR=11.61; P=0.000) and antiretroviral prophylaxis (OR=2.70; P=0.0344). The survival rate was 84.3% in infants who were receiving HAART as opposed to 43.3% in those who were not (P<0.05). CONCLUSIONS HIV infected women who are eligible should start antiretroviral treatment prior to a pregnancy, in order to improve their immunological status. This measure associated to cotrimoxazole prophylaxis and ART could improve their survival.
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Affiliation(s)
- Félicitée Nguefack
- 1 Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Cameroon ; 2 Gynaeco-Obstetric and Paediatric Hospital, P.o. Box 4362, Yaoundé, Cameroon ; 3 District Hospital Efoulan PO. Box 1113-Yaoundé, Cameroon ; 4 Mother and Child Centre of the Chantal Biya Foundation, P.O. Box 1444, Yaoundé, Cameroon
| | - Roger Dongmo
- 1 Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Cameroon ; 2 Gynaeco-Obstetric and Paediatric Hospital, P.o. Box 4362, Yaoundé, Cameroon ; 3 District Hospital Efoulan PO. Box 1113-Yaoundé, Cameroon ; 4 Mother and Child Centre of the Chantal Biya Foundation, P.O. Box 1444, Yaoundé, Cameroon
| | - Carole Leïla Touffic Othman
- 1 Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Cameroon ; 2 Gynaeco-Obstetric and Paediatric Hospital, P.o. Box 4362, Yaoundé, Cameroon ; 3 District Hospital Efoulan PO. Box 1113-Yaoundé, Cameroon ; 4 Mother and Child Centre of the Chantal Biya Foundation, P.O. Box 1444, Yaoundé, Cameroon
| | - Sandra Tatah
- 1 Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Cameroon ; 2 Gynaeco-Obstetric and Paediatric Hospital, P.o. Box 4362, Yaoundé, Cameroon ; 3 District Hospital Efoulan PO. Box 1113-Yaoundé, Cameroon ; 4 Mother and Child Centre of the Chantal Biya Foundation, P.O. Box 1444, Yaoundé, Cameroon
| | - Mina Ntoto Njiki Kinkela
- 1 Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Cameroon ; 2 Gynaeco-Obstetric and Paediatric Hospital, P.o. Box 4362, Yaoundé, Cameroon ; 3 District Hospital Efoulan PO. Box 1113-Yaoundé, Cameroon ; 4 Mother and Child Centre of the Chantal Biya Foundation, P.O. Box 1444, Yaoundé, Cameroon
| | - Paul Olivier Koki Ndombo
- 1 Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, P.O. Box 1364, Cameroon ; 2 Gynaeco-Obstetric and Paediatric Hospital, P.o. Box 4362, Yaoundé, Cameroon ; 3 District Hospital Efoulan PO. Box 1113-Yaoundé, Cameroon ; 4 Mother and Child Centre of the Chantal Biya Foundation, P.O. Box 1444, Yaoundé, Cameroon
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Emina JBO, Madise N, Kuepie M, Zulu EM, Ye Y. Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model. BMJ Open 2013; 3:bmjopen-2012-002459. [PMID: 23793677 PMCID: PMC3657656 DOI: 10.1136/bmjopen-2012-002459] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi. DESIGN A cross-sectional survey. SETTING Malawi PARTICIPANTS The study used a sample of 6395 women aged 15-49 years from the 2010 Malawi Health and Demographic Surveys. INTERVENTIONS N/A PRIMARY AND SECONDARY OUTCOME MEASURES Individual HIV status: positive or not. RESULTS Findings from the Pearson χ(2) and χ(2) Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15-24) never married or in union and living in rural areas. CONCLUSIONS In the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25-49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30-49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment.
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Affiliation(s)
- Jacques B O Emina
- Department of Population and Development Studies, University of Kinshasa, Kinshasa XI, Democratic Republic of Congo
- AFRILUX, CEPS/INSTEAD 3, Esch-sur-Alzette, Luxembourg
- Research Coordination, INDEPTH Network, Accra, Ghana
| | - Nyovani Madise
- Faculty of Social and Human Sciences, University of Southampton, Southampton, UK
| | | | - Eliya M Zulu
- African Institute for Development Policy (AFIDEP), Westlands, Nairobi, Kenya
| | - Yazoume Ye
- ICF International, Calverton, Maryland, USA
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Aebi-Popp K, Mulcahy F, Rudin C, Hoesli I, Gingelmaier A, Lyons F, Thorne C. National Guidelines for the prevention of mother-to-child transmission of HIV across Europe - how do countries differ? Eur J Public Health 2013; 23:1053-8. [DOI: 10.1093/eurpub/ckt028] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Buchanan AM, Nadjm B, Amos B, Mtove G, Sifuna D, Cunningham CK, Crump JA, Reyburn H. Utility of rapid antibody tests to exclude HIV-1 infection among infants and children aged <18 months in a low-resource setting. J Clin Virol 2012; 55:244-9. [PMID: 22925720 DOI: 10.1016/j.jcv.2012.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Revised: 06/20/2012] [Accepted: 08/01/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Excluding HIV infection among infants and young children in resource-poor settings where nucleic acid amplification tests (NAAT) are not routinely available remains a considerable challenge. OBJECTIVES To assess the performance of two rapid HIV antibody tests (RT) used alone and in parallel for excluding HIV infection among acutely ill infants and children <18 months in comparison to NAAT in a region where maternal HIV prevalence was approximately 7%. STUDY DESIGN Infants and children ≥2<18 months admitted to hospital with an acute febrile illness had two rapid antibody tests in parallel, with single and parallel results subsequently compared against NAAT. RESULTS HIV prevalence among 1602 enrolled infants was 3.4%. All 1526 infants with 2 negative RT were HIV negative by NAAT. All 46 infants with 2 positive RT were HIV positive by NAAT. The overall specificity of two rapid tests for excluding HIV infection was 99.5%. Sensitivity and specificity were ≥99% and >98%, respectively, across all age brackets ≥2<18 months. Overall sensitivity and specificity for a single RT was 98.2% and 99%, respectively, for Determine, and 85.5% and 99.6%, respectively, for Capillus. CONCLUSIONS In a setting with a maternal HIV prevalence rate of <10%, a single negative RT had excellent specificity and two negative RT performed in parallel had a perfect negative predictive value for HIV infection among acutely ill patients <18 months of age. In this and similar settings, RT could assist with excluding HIV infection with much lower complexity and cost than NAAT.
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Affiliation(s)
- Ann M Buchanan
- Division of Infectious Diseases, Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
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Hạnh NTT, Gammeltoft TM, Rasch V. Number and timing of antenatal HIV testing: evidence from a community-based study in Northern Vietnam. BMC Public Health 2011; 11:183. [PMID: 21439043 PMCID: PMC3078880 DOI: 10.1186/1471-2458-11-183] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Accepted: 03/25/2011] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND HIV testing for pregnant women is an important component for the success of prevention of mother-to-child transmission of HIV (PMTCT). A lack of antenatal HIV testing results in loss of benefits for HIV-infected mothers and their children. However, the provision of unnecessary repeat tests at a very late stage of pregnancy will reduce the beneficial effects of PMTCT and impose unnecessary costs for the individual woman as well as the health system. This study aims to assess the number and timing of antenatal HIV testing in a low-income setting where PMTCT programmes have been scaled up to reach first level health facilities. METHODS A cross-sectional community-based study was conducted among 1108 recently delivered mothers through face-to-face interviews following a structured questionnaire that focused on socio-economic characteristics, experiences of antenatal care and HIV testing. RESULTS The prevalence of women who lacked HIV testing among the study group was 10% while more than half of the women tested had had more than two tests during pregnancy. The following factors were associated with the lack of antenatal HIV test: having two children (aOR 2.1, 95% CI 1.3-3.4), living in a remote rural area (aOR 7.8, 95% CI 3.4-17.8), late antenatal care attendance (aOR 3.6, 95% CI 1.3-10.1) and not being informed about PMTCT at their first antenatal care visits (aOR 7.4, 95% CI 2.6-21.1). Among women who had multiple tests, 80% had the second test after 36 weeks of gestation. Women who had first ANC and first HIV testing at health facilities at primary level were more likely to be tested multiple times (OR 2.9 95% CI 1.9-4.3 and OR = 4.7 95% CI 3.5-6.4), respectively. CONCLUSIONS Not having an HIV test during pregnancy was associated with poor socio-economic characteristics among the women and with not receiving information about PMTCT at the first ANC visit. Multiple testing during pregnancy prevailed; the second tests were often provided at a late stage of gestation.
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Affiliation(s)
- Nguyễn TT Hạnh
- Department of Population, Institute for Preventive Medicine and Public Health, Hanoi Medical University, No.1 Ton That Tung Street, Khuong Thuong, Dong Da, Hanoi, Vietnam
| | - Tine M Gammeltoft
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, DK-1353 Copenhagen K, Denmark
| | - Vibeke Rasch
- Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark
- Department of Obstetrics and Gynaecology, Odense University Hospital, 5000 Odense C, Denmark
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Quantitative recovery of proviral HIV-1 DNA from leukocytes by the Dried Buffy Coat Spot method for real-time PCR determination. J Virol Methods 2010; 170:121-7. [PMID: 20863854 DOI: 10.1016/j.jviromet.2010.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 09/07/2010] [Accepted: 09/13/2010] [Indexed: 02/02/2023]
Abstract
The current recommended method for diagnosing HIV-1 in newborns infected vertically and in adults, during the "window period", is the detection of proviral HIV-1 DNA within leukocytes (buffy coat). This study describes a new portable Dried Buffy Coat Spot (DBCS) assay able to provide a quantitative proviral HIV-1 DNA recovery from the buffy coat. Fifty blood samples were collected from HIV-positive children and processed for DBCSs. Total DNA and proviral DNA were normalised to β-globin and HIV-1 pol genes. Assay sensitivity and specificity were evaluated against the whole blood dried blood spot (DBS) method. Both procedures, using automatic DNA extraction, were compared to a standard whole blood DNA manual extraction. DNA recovery from whole blood was nearly equivalent to that of the DBCS-based extraction, while DBS-based extraction was 10-fold less sensitive. The detection rate of proviral HIV-1 DNA with DBCS assay was equivalent to whole blood manual extraction (100% concordance), but DBS-extracted samples showed limited concordance (44%). The DBCS assay may prove to be more feasible in resource-limited settings. It may represent a simple and robust point-of-care assay for HIV screening of children, for whom a reference test is still lacking.
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Reply to Black et al. High HIV incidence or poor test performance? AIDS 2009. [DOI: 10.1097/qad.0b013e3283315636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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