Abstract:
Aim: To determine the association between the age at initiation of anti-retroviral therapy
(ART) and the 18 month antibody status of human immunodeficiency virus (HIV)-infected
children in Jos, Nigeria.
Study Design: This was a retrospective cohort study.
Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported
HIV clinic at Jos University Teaching Hospital, Jos, Nigeria between July 2008 and June
2012.
Methods: We reviewed the clinical records of all children confirmed to be HIV-infected
with 2 positive HIV deoxyribonucleic acid polymerase chain reaction (DNA PCR) results
who were initiated on ART before 12 months of age. We studied the association between
the age at initiation of ART and their antibody status at 18months of age. We also
studied the association between the viral load and the antibody status.Result: Seventy-three HIV-infected children were initiated on ART at <12 months of age,
66 of these had antibody tests at 18-21 months of age. Nineteen (29%) of the 66 children
were negative for rapid antibody test. Those that were initiated on ART at <6 months of
age had 5 times the odds ratio of being rapid antibody test negative compared to those
who were initiated at ≥6 months of age (AOR=5.23 (1.82-19.66), P=0.002). All the
children with negative rapid antibody tests were virally suppressed while all those with
detectable viral load were positive for rapid antibody tests.
Conclusion: Antibody tests alone cannot be used to determine whether ART should be
stopped in children where a definitive diagnosis does not exist. Improved access to
affordable, technically simple DNA PCR testing is essential for the appropriate
management of HIV-exposed infants in resource limited settings
