Screening for ‘window‐period’ acute HIV infection among pregnant women in rural South Africa |
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| Authors: | ABM Kharsany N Hancock JA Frohlich HR Humphries SS Abdool Karim Q Abdool Karim |
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| Affiliation: | 1. Centre for the AIDS Programme of Research in South Africa (CAPRISA), Doris Duke Medical Research Institute, Nelson R Mandela School of Medicine, University of KwaZulu‐Natal, Durban, South Africa;2. Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston‐Salem, NC, USA;3. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA |
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| Abstract: | ![]()
Objectives The aim of this study was to evaluate the HIV‐1 RNA pooled nucleic acid amplification testing (NAAT) strategy to screen pregnant women in the ‘window period’ of acute HIV infection (AHI) in rural South Africa. Methods In 2007 and 2008, 750 consecutive pregnant women on their first antenatal care visit to a primary health care clinic were tested anonymously for HIV infection. HIV‐1 RNA pooled NAAT was performed on HIV antibody‐negative samples. All positive pools were tested individually and positive samples were classified as incident cases to calculate HIV incidence. Results The overall HIV prevalence was 37.3% [95% confidence interval (CI) 34.3–41.3]. Of the 467 HIV antibody‐negative samples, four (0.9%) were HIV‐1 RNA‐positive. The mean viral load in the four samples was 386 260 HIV‐1 RNA copies/mL (range 64 200–1 228 130). The HIV incidence was 11.2% per year (95% CI 0.3–22.1) and all women with AHI were ≤21 years of age. Conclusions Identifying AHI in pregnancy is important for health interventions to reduce perinatal and heterosexual transmission of HIV, and to estimate HIV incidence for epidemiological surveillance. |
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| Keywords: | acute HIV infection HIV‐1 RNA pregnant women rural South Africa screening |
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