HIV diagnosis and ARV use in HIV-exposed infants: a programmatic update

Overview

New HIV infections in children continue to occur globally and timely diagnosis and treatment of infants and children living with HIV remain critically important. The 2016 WHO ARV Consolidated Guidelines presented some innovative approaches, such as the use of nucleic acid testing ( NAT) at or around birth for earlier diagnosis of HIV in infants, the introduction of point-of-care ( POC) NAT for more rapid and decentralized diagnosis to enable prompt antiretroviral therapy (ART) initiation, and the use of enhanced postnatal prophylaxis (ePNP) to improve HIV prevention among infants exposed to HIV.

To date, however, only a few countries have introduced these innovations and early lessons from the field have identified a number of implementation challenges that require careful review.

Drawing on findings from a regional workshop held in Johannesburg, South Africa in 2017 and a follow-up expert meeting in Geneva, Switzerland in 2018, this programmatic update aims to describe changes in strategies for the identification, prevention and treatment of HIV in infants. This update will also highlight new information on the implementation of a postnatal package of care for HIV- exposed infants.