HIV – more extensive HIV screening to be accessible to the countries of the South

[12 April 2010 - 10h11]

The implementation of procedures that will diagnose HIV infection as early as the first few weeks of life will improve our understanding of the factors involved in mother-to-child transmission and support earlier treatment. New tests that are less costly and more manageable than their predecessors have become available during the last few months and were presented at the 5th Francophone Conference on HIV/AIDS held in Casablanca, Morocco.

These tests were developed during the first half of 2009 in response to a request from UNICEF who wished to see HIV screening extended. Created by the American healthcare company Abbott – which invented the first diagnostic test approved in the United States in 1985 – they extract the virus’s RNA on to blotting paper. Using either full blood or plasma, this DBS technology can be carried out either robotically or manually. Above all, it is compatible with the often difficult logistical conditions prevailing in countries of the South.

Blood is taken from an infant’s heel from the sixth week of life onwards and “placed” on blotting paper where it can be safely preserved. As Dr Aurore Ogouyemi-Hounto of the University of Cotonou, Benin explains, the samples are then simply “collected by a courier firm” and taken “to the National AIDS Control Programme reference laboratory (PNLS). Some of the negative samples and all the positive ones will then be measured for viral load”.

In Burkina Faso, another team has also assessed this technique and reports “a very good correlation to the quantification of viral RNA conducted on plasma”. Dr Lassana Sangaré of the University of Ouagadougou sees this approach as “offering numerous advantages in countries with limited resources as it requires less logistical support and the use of fewer samples”. And above all, “it can be extended to early diagnosis of HIV infection in children (thus supporting) more rapid treatment of a wider population”.

Benefiting from cooperation between Abbott, who developed and produces the tests, and the Bill Clinton Foundation which will purchase them “at cost price”, this technique should make it possible to establish screening across a broad population base. Estimated at about 3 American dollars, the unit cost of the test should increase accessibility to early diagnosis for children and lead to a reduction in healthcare costs. It is also and at the same time “a good indicator of the follow-up of mother-to-child transmission prevention programmes (MTCT) and a basic indicator for paediatric treatment and care of HIV”.

Source : our special correspondent at the 5th Francophone HIV/AIDS Conference, Casablanca, 28-31 March 2010.

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