婴儿早期HIV诊断：当前及创新实践综述
Early infant diagnosis of HIV: review of current and innovative practices.
作者信息
Celletti Francesca, Sherman Gayle, Mazanderani Ahmad H
机构信息
aElizabeth Glaser Pediatric AIDS Foundation, Geneva 2 bGeneva School of Diplomacy, Geneva, Switzerland cCentre for HIV & STI, National Institute for Communicable Diseases dDepartment of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg eDepartment of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
出版信息
Curr Opin HIV AIDS. 2017 Mar;12(2):112-116. doi: 10.1097/COH.0000000000000343.
PURPOSE OF REVIEW
Only 51% of HIV-exposed infants receive an HIV test between 4 and 6 weeks of age, with even lower repeat testing rates at older ages, and only 49% of infants tested are initiated on antiretroviral therapy. The purpose of this article is to discuss potential solutions for increasing coverage of early infant diagnosis (EID), decreasing turnaround time for result return, improving linkages to care and treatment and fulfilling the objective of improving outcomes for HIV-infected children.
RECENT FINDINGS
Differences in HIV testing guidelines have emerged in different countries, with some recommending HIV testing at birth. Although EID programs are not yet optimal, some solutions have proven successful including the use of short message service printers, community-based interventions and support and education of mothers. Birth and EID point-of-care testing have emerged as potential game changers for improving EID programs.
SUMMARY
For EID programs to impact on child health outcomes, by preventing HIV-associated morbidity and mortality, and provide more value than a mere surveillance tool, efforts need to be aligned toward the implementation of a comprehensive set of interventions that take cognizance of different contexts, epidemiology and health systems, and that are backed by political and community support.
综述目的
在暴露于HIV的婴儿中，只有51%在4至6周龄时接受了HIV检测，年龄较大时重复检测率更低，且接受检测的婴儿中只有49%开始接受抗逆转录病毒治疗。本文旨在探讨增加早期婴儿诊断（EID）覆盖率、缩短结果反馈周转时间、改善护理和治疗联系以及实现改善HIV感染儿童预后目标的潜在解决方案。
最新发现
不同国家出现了HIV检测指南的差异，一些国家建议在出生时进行HIV检测。虽然EID项目尚未达到最佳状态，但一些解决方案已被证明是成功的，包括使用短信服务打印机、基于社区的干预措施以及对母亲的支持和教育。出生时和EID即时检测已成为改善EID项目的潜在变革因素。
总结
为使EID项目能够通过预防与HIV相关的发病和死亡来影响儿童健康结果，并提供比单纯监测工具更多的价值，需要努力实施一套全面的干预措施，这些措施要考虑到不同的背景、流行病学和卫生系统，并得到政治和社区的支持。
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