Technau, K.G., Kunn, L., Coovadia, A., Murnane, P.M., Sherman, G. The Lancet HIV (July 2017), doi: 10.1016/52352-3018(17)030097-8.
This study described point-of-care testing (POCT) for HIV-exposed newborns and compares outcomes to universal laboratory-based testing (LABT). Mothers of 3,097 infants agreed to participate; 2,238 of these infants concurrently received POCT and LABT. Of the 3,970 infants undergoing LABT at birth, 57 were positive. Of the 2,238 infants undergoing POCT, 32 were positive. All infants identified as HIV-positive by LABT were also identified by POCT. There were two false positives among infants undergoing POCT. For LABT, median turnaround time from blood draw to return of result was 43 hours; for POCT it was 2.6 hours. Mothers whose infants received POCT and LABT received their results in 96 percent of cases, while only 53 percent of mothers whose infants received LABT received their results. Of the 30 infants diagnosed through POCT as HIV-positive, all mothers received the result, and all infants started antiretroviral therapy (ART). Of the 27 infants diagnosed through LABT as HIV-positive, 24 mothers received the result, and all of their infants started ART. Infants diagnosed via POCT initiated treatment earlier than infants diagnosed via LABT (one day versus six days). The authors concluded that POCT is accurate, increases the likelihood of the mother receiving the result, reduces waiting time for the result, and decreases time to ART initiation.