Early Infant HIV Diagnosis and Antiretroviral Therapy

Early infant diagnosis and prompt initiation of antiretroviral therapy constitute a cornerstone of paediatric HIV care. Infants infected perinatally face rapid disease progression and high mortality if untreated; commencing therapy within the first weeks of life can reduce mortality by up to three-quarters. Diagnosis relies on nucleic acid tests on dried blood spots or near point-of-care platforms, often deployed within tiered laboratory networks to overcome challenges of transport and result turnaround. Universal cotrimoxazole prophylaxis is administered to HIV-exposed infants until infection is ruled out and vertical transmission risk has ceased. Integration of infant testing into broader child health services, combined with mobile technologies for result delivery and strengthened sample referral systems, has improved access but persistent barriers—such as limited resources for point-of-care testing and caregiver engagement—continue to delay diagnosis and treatment initiation. Continued innovation in assay technology, service delivery models and health-system integration remains vital to closing gaps in the early infant diagnosis cascade and ensuring timely antiretroviral therapy for every infected infant.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Early Infant HIV Diagnosis and Antiretroviral Therapy publication trend

The graph below shows the total number of articles in early infant hiv diagnosis and antiretroviral therapy across all publications each year (not limited to Nature Index journals).

Technical terms

Early Infant Diagnosis (EID): the process of testing infants for HIV, typically within the first two months of life, using molecular assays to detect viral genetic material.

Antiretroviral Therapy (ART): combination drug regimens that suppress HIV replication, preserve immune function and reduce morbidity and mortality in infected individuals.

Point-of-Care (POC) testing: diagnostic assays performed at or near the site of patient care, delivering rapid results to enable immediate clinical decision-making.

Vertical Transmission: the passage of HIV from mother to child during pregnancy, delivery or breastfeeding.

Cotrimoxazole Prophylaxis: administration of an antibiotic combination to prevent Pneumocystis jirovecii pneumonia and other opportunistic infections in HIV-exposed infants.

References

1. Estimating the impact of alternative programmatic cotrimoxazole strategies on mortality among children born to mothers with HIV: A modelling study. PLOS Medicine (2024).
2. Examining barriers to antiretroviral therapy initiation in infants living with HIV in sub‐Saharan Africa despite the availability of point‐of‐care diagnostic testing: a narrative systematic review. Journal of the International AIDS Society (2024).
3. Building Integrated Testing Programs for Infectious Diseases. The Journal of Infectious Diseases (2023).
4. Uganda's New National Laboratory Sample Transport System: A Successful Model for Improving Access to Diagnostic Services for Early Infant HIV Diagnosis and Other Programs. PLOS ONE (2013).
5. Early infant diagnosis of HIV infection in Zambia through mobile phone texting of blood test results. Bulletin of the World Health Organization (2012).