EARLY INFANT DETECTION OF HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION USING DRIED BLOOD SPOTS AT A TERTIARY CARE HOSPITAL IN RIVERS STATE, NIGERIA

Agamini Warri Agamini, Samuel Douglas Abbey and Easter Godwin Nwokah*

ABSTRACT

Children born to HIV-positive mothers are likely to acquire maternal antibody which has made early infant detection of HIV challenging, using conventional screening methods. This study was aimed to provide early diagnosis of HIV infection in infants born to infected mothers using molecular method in comparison to the screening method. This study covered 134 infants born to HIV-sero-positive mothers attending antenatal clinics at the Braithwaite Memorial Specialist Hospital (BMSH) in Port Harcourt, Nigeria, between October 2016 and September 2017. Following ethical approval and informed consent, the infants Sero-status was determined using the National serial screening algorithm to identify anti-HIV-1 and anti-HIV-2 antibodies in the blood. Concordance positive test was regarded as positive; while discordant results were resolved using the third test kit as tie breaker. Early infant detection (EID) of viral DNA using dried blood spots (DBS) samples was performed using Roche COBAS ® Ampliprep/COBAS TaqMan HIV-1 Quali Test instrumentation. Of the 134 infants, aged between 6 weeks and 18 months tested, 52 were males and 82 were females. 76 (56.7%) tested sero-positive with the rapid diagnostic test (RDT) while 16 (11.9%) tested positive with the polymerase chain reaction (PCR) method (P<0.05) using the dried blood spots (DBS) samples. The overall result showed that the infants within the age bracket of 1 to 4 months had the highest positive cases with the RDT- 68 (58.1%) and PCR results 14 (12.0%). This was closely followed by 9 to 12 months which recorded 57.1% for RDT but no target detected with the PCR method. On gender-related occurrence of HIV among the infants tested, Eight male infants were positive in the PCR out of the fifty-two infants tested, while eight (9.8%) out of the eighty-two (82) female subjects also showed positive results with PCR method. With the RDT method, 47(57.3%) and 29 (55.8%) tested positive among the females and the males respectively. The result showed a great disparity in prevalence between the two methods of detection. Within the early weeks of life, maternal antibodies prevailed in the infants’ blood which declined at later period of life, leading to false positive results and this is of great concern. Early identification of HIV in infants, based on Viral DNA detection should be encouraged in our clime. This will improve management and outcomes, reduce side effects of unnecessary administration of Anti Retroviral Therapy (ART), as well as conserve scarce resources.

Keywords: Early Infant HIV-Detection, DBS, Maternal-antibodies, Viral DNA.