KẾT QUẢ CHẨN ĐOÁN SỚM NHIỄM HIV CHO TRẺ DƯỚI 18 THÁNG TUỔI KHU VỰC TỪ HUẾ TRỞ VÀO NAM NĂM 2022

Abstract

The Vietnamese Ministry of Health has released updated National Guidelines on HIV care and treatment, outlined in Decision 5968/QD-BYT dated December 21, 2021. This guideline aims to support the national target to eliminate mother-to-child transmission (MTCT) of HIV by 2030. One significant aspect of this guideline is the strong emphasis on early infant diagnosis (EID) of HIV infection among children under 18 months of age, particularly within the first 2 days of life and as soon as possible thereafter. This guideline recommends the use of nucleic acid tests employing molecular techniques.
Objectives: A survey was conducted to collect data obtained from the EID of HIV infection in children under 18 months of age, aligning with the updated guidelines. The primary objective of the survey was to assess the effectiveness of the program to prevent MTCT of HIV and to identify factors that may be associated with the transmission of HIV from mother to child.
Subjects and methods: Cross-sectional study on children under 18 months old exposed or suspected of being infected with HIV being managed/examined at pediatric outpatient clinics in regional provinces/cities from Hue to the South in 2022.
Results and conclusions: In 2022, a total of 893 dried blood spot (DBS) specimens were collected for EID tests from Hue to Southern provinces. Out of those, 26 (2.9%) children were positive for HIV-1 infection using the real-time PCR technique. The prevalence of HIV-1 infection among children under 18 months of age varied based on the level of preventive actions: 0.7% for those who received adequate prevention, 5.4% for those with incomplete prevention, and 42.3% (p < 0.001) for those without any intervention. Factors associated with the MTCT of HIV include the full or partial participation in a program to prevent MTCT of HIV (p < 0.001), the timing of the child's diagnosis (p < 0.001), and the timing of the mother's HIV infection onset (p < 0.001).
Despite the rate of perinatal transmission decreasing based on the effort to widely implement the PMTCT program, there are still cases where pregnant women with HIV have not accessed the intervention which demonstrates a high rate of HIV transmission (42.3%). Therefore, it is crucial to keep continuing efforts to enhance access and uptake of these interventions, which will further reduce the incidence of mother-tochild transmission of HIV.