South Africa: All Babies Should Have HIV Tests, Says Expert

Compulsory HIV testing for six-week-old infants would help the South African government assess whether giving nevirapine to stop mother-to-child transmission is working, an AIDS expert said at the International All 4 Children Congress in Sun City over the weekend.

To determine the efficacy of nevirapine, said Professor Nigel Rollins, "you need to test the child after delivery." "The difficulty is most of the women undergo the initial prevention of mother-to-child transmission and never return to the clinics after delivery. So you cannot know whether transmission has been avoided," he said.

In a paper titled "HIV Prevalence Rates Among 6-Week-Old Infants in South Africa: The Case for the Universal Screening at Immunisation Clinics," Rollins and colleagues at the Nelson R. Mandela School of Medicine studied clinics in four districts in KwaZulu-Natal province. They drew blood from 2,473 women to determine mother-to-child transmission rates. Prior to the tests, the women were asked about their HIV status during pregnancy.

A total of 486 women confirmed their HIV status and received nevirapine, 232 did not disclose their status, and 189 said they were HIV-negative. Rollins said 37.6 percent (907) of the women had HIV and 189 children (7.6 percent) were infected for a transmission rate of 20.8 percent. Mothers who confirmed their HIV status had the lowest transmission rate (15.8 percent) while those who claimed they were negative had the highest (31.2 percent). Those who did not disclose their status had a 22.8 percent transmission rate.

Testing would provide a second chance for women to learn their status and that of their infant as well, said Rollins. This would enable health authorities to immediately refer mother and child for HIV care.

Professor Raziya Bobat, the head of the South African Pediatrics Association, which sponsored the conference, promised to submit Rollins' proposal to the health minister.

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