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Profiles of HIV-infected anti-retroviral therapy naïve children from Mumbai,India

世界儿科杂志:英文版 2016年第4期12卷 430-435页

作者： Supriya Mayur Paranjpe purva pankaj sarkate Nayana Avinash Ingole Shweta Sadanand Raut Preeti Rajeev Mehta Department of Microbiology 5th floorMulti-Storey BuildingSeth G.S.Medical College and K.E.M.HospitalParelMumbaiIndia

Background:This study aimed to investigate the demographic profiles of human immunodifficiency virus(HIV)infected anti-retroviral therapy(ART)naïve children in our hospital and their relations to the clinical,immunological and nutritional ***:A cross-sectional study was conducted in an Integrated Counselling and Testing Center(ICTC)at a tertiary care hospital in *** naïve HIV positive children were enrolled in the *** demographic profiles,clinical features,immunological(CD4%/CD4 count)and nutritional status of these children were *** agreement between clinical,immunological and nutritional staging was determined using Cohen’s kappa ***:In 192 HIV-infected ART naive children enrolled with a median age of 9 years(range 3 months-14 years),97.4%acquired infection through vertical *** most common clinical presentation was fever(39.6%),followed by generalized lymphadenopathy(32.3%),cough(22.4%)and diarrhoea(9.9%).Tuberculosis was seen in 22.9%of the *** agreement was fair between clinical and immunological staging,and slight between nutritional,immunological and clinical ***:Perinatal transmission is the most common mode of acquiring HIV infection in *** Prevention of Parent to Child Transmission(PPTCT)program should be strengthened for lowering the transmission rate by providing extended ART to mothers during pregnancy and *** remains a major concern in HIV-infected *** poor correlation between WHO clinical and immunological staging emphasizes the importance of making CD4 facilities available in HIV prevalent *** cannot be used as a surrogate marker for predicting stage or severity as it is common at all stages of HIV disease.

关键词： anti-retroviral therapy CD4 count clinical stage HIV nutritional status

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HIV Diagnosis in Resource Constrained Setting: How Good Is the Current Algorithm?

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World Journal of AIDS 2014年第1期4卷 45-51页

作者： Nayana Ingole purva sarkate Supriya Paranjpe Rahul Sarode Sameer Shinde Preeti Mehta Department of Microbiology Seth G S Medical College and KEM Hospital Parel Mumbai India

Background: The conventional HIV testing algorithm in most of the developed countries consists of two tests: an HIV enzyme immunoassay capable of identifying HIV-1 and HIV-2 antibodies and a confirmatory HIV-1 Western blot or immunofluorescence assay. However, the current algorithm for HIV diagnosis in India uses three sequential antibody assays. There has always been doubt regarding the benefits of this algorithm. Objective: To determine the utility of the current diagnostic algorithm and to find out the proportion of indeterminate or discrepant results. Methods: Retrospective analysis of HIV antibody testing data was carried out over a period of five years after institutional ethics committee approval. The specimens positive with the screening test and negative with both the supplemental tests were labeled as discrepant. Specimens positive with any of the two tests (screening and one of the supplemental tests) and negative with the remaining supplemental test were labeled as indeterminate. These indeterminate specimens were confirmed by immunoblotting. Results: A total of 141,296 samples were tested. Of these, 71 (0.05%) samples were indeterminate and 292 (0.21%) were discrepant. Western blot was done on 60 indeterminate samples of which 10 (16.67%) were positive for HIV 1 antibodies, 14 (23.33%) were negative for HIV antibodies and 36 (60%) had indeterminate result. Conclusion: In view of the low numbers of indeterminate and discrepant results, the current algorithm appears to be appropriate in our resource constrained setting. However, the algorithm for HIV testing should also include DNA PCR testing facility to resolve western blot indeterminate results.

关键词： HIV Indeterminate Discrepant Rapid Tests Western Blot Algorithm

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