Evaluation of an in-house molecular HIV-1 test to assess mother-to-child HIV-1 transmission in Angola (the APEHC cohort)

Abstract

"Mother-to-child-transmission (MTCT) rate has decreased sharply in recent years in most of the sub-Saharan Africa, however 220,000 children acquired HIV-1 in 2014. PCR detection of proviral DNA is the most sensitive method for early infant diagnosis (EID) of HIV-1 infection. Commercial kits are available but they have poor sensitivity with divergent non-B subtypes and high costs (≈30€ per test) which limit their use in resource-limited settings. The HIV-1 epidemic in Angola is driven by highly divergent strains of all group M subtypes, except B, as well as multiple recombinant forms (CRFs and URFs) making EID a challenge in this setting. The aim of this study was to develop and validate a qualitative, inexpensive and sensitive “inhouse” HIV-1 EID assay on heel prick dried blood spots (DBS) from infants of the Hospital da Divina Providência (HDP) in Luanda, Angola and determine the current HIV-1 MTCT rate in the Angolan PErinatal HIV Cohort (APEHC)."