Bibliographic Info
GuidelineGuidelines: updated recommendations on HIV prevention, infant diagnosis, antiretroviral initiation and monitoring
Year of Publication2021
Issuing InstitutionWHO
Recommendation
Status
Updated
Recommended in favor
Strong
Certainty of evidence
High
Point-of-care nucleic acid testing should be used to diagnose HIV among infants and children younger than 18 months of age.
Notes and Remarks
- 1.First, point-of-care infant diagnosis technologies should be considered and used within the current infant diagnosis algorithm at any point when a nucleic-acid test is required (24) (Annex 2).
- 2.Second, access to high-quality diagnostic testing should be continually expanded across HIV and other molecular testing needs, ideally combining laboratory-based and point-of-care technologies in an integrated diagnostic network. If point-of-care testing cannot be done, alternative options must be found, including ensuring rapid laboratory-based testing. Optimal placement of point-of-care technologies should be considered within the context of the overall health system, including other disease programmes and needs. This will create efficiency and support expansion and improved diagnostic services for HIV and other diseases (TB, HIV viral load, etc.). Finally, ensuring adequate human resources, training (including technical, result interpretation, counselling and supply chain), service and maintenance and quality assurance should be carefully considered. Clear messaging, communication and literacy considerations should be implemented to support demand generation, scale-up, trust and utilization, including close collaboration with community groups. Maximizing the clinical impact of point-of-care testing requires ongoing strengthening of treatment and care services for neonates, infants and children, same-day linkage of infants to treatment and care, reliable procurement of appropriate formulations for children and supported supervision for health-care workers managing these young infants.