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首页> 外文期刊>AIDS Research and Human Retroviruses >Implementation of HIV Early Infant Diagnosis and HIV Type 1 RNA Viral Load Determination on Dried Blood Spots in Cameroon: Challenges and Propositions
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Implementation of HIV Early Infant Diagnosis and HIV Type 1 RNA Viral Load Determination on Dried Blood Spots in Cameroon: Challenges and Propositions

机译：在喀麦隆干血斑上实施HIV婴儿早期诊断和HIV 1型RNA病毒载量的测定：挑战和主张

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The testing of dried blood spots (DBSs) for human immunodeficiency type 1 (HIV-1) proviral DNA by PCR is a technology that has proven to be particularly valuable in diagnosing exposed infants. We implemented this technology for HIV-1 early infant diagnosis (EID) and HIV-1 RNA viral load determination in infants born of HIV-1-seropositive mothers from remote areas in Cameroon. The samples were collected between December 2007 and September 2010. Fourteen thousand seven hundred and sixty-three (14,763) DBS samples from infants born of HIV-positive mothers in 108 sites nationwide were tested for HIV. Of these, 1452 were positive on first PCR analyses (PCR1), giving an overall infection rate of 12.30%. We received only 475 DBS specimen for a second PCR testing (PCR2); out of these, 145 were positive. The median HIV-1 RNA viral load for 169 infant DBS samples tested was 6.85 log copies/ml, with values ranging from 3.37 to 8 log copies/ml. The determination of the viral load on the same DBS as that used for PCR1 allowed us to bypass the PCR2. The viral load values were high and tend to decrease with age but with a weak slope. The high values of viral load among these infants call for early and effective administration of antiretroviral therapy (ART). The findings from this study indicate that the use of DBS provides a powerful tool for perinatal screening programs, improvement on the testing algorithm, and follow-up during treatment, and thus should be scaled up to the entire nation.
机译：通过PCR检测人类1型免疫缺陷病毒（HIV-1）原病毒DNA的干血斑（DBS）是一项已被证明在诊断接触婴儿方面特别有价值的技术。我们对喀麦隆偏远地区的HIV-1血清阳性母亲所生婴儿实施了HIV-1早期婴儿诊断（EID）和HIV-1 RNA病毒载量测定技术。样本是在2007年12月至2010年9月之间收集的。在全国108个地点对来自艾滋病毒呈阳性母亲的婴儿的一万四千六百三十六（14,763）个DBS样本进行了艾滋病毒检测。其中，有1452例在首次PCR分析（PCR1）中呈阳性，总感染率为12.30％。我们仅收到475个DBS标本进行第二次PCR测试（PCR2）;其中，145例为阳性。测试的169例婴儿DBS样本的HIV-1 RNA病毒中位数为6.85对数/毫升，值范围为3.37至8对数/毫升。在与用于PCR1的DBS相同的DBS上确定病毒载量可以使我们绕过PCR2。病毒载量值很高，并且会随着年龄的增长而降低，但斜率较弱。这些婴儿中较高的病毒载量要求尽早有效地进行抗逆转录病毒治疗（ART）。这项研究的结果表明，DBS的使用为围产期筛查计划，测试算法的改进和治疗期间的随访提供了强大的工具，因此应扩大到整个国家。

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