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Reducing the burden of HIV/AIDS in infants: the contribution of improved diagnostics

Nature volume 444, pages 19–28 (2006)Cite this article

The development of an inexpensive, simple and widely accessible test for diagnosing human immunodeficiency virus (HIV) infection in infants could significantly reduce paediatric acquired immunodeficiency syndrome (AIDS) deaths in sub-Saharan Africa.

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Figure 1: Human immunodeficiency virus (HIV) paediatric diagnostic decision trees.
Figure 2
Figure 3: Elasticity of outcome with respect to input parameters for a 90% sensitive and 90% specific test that can be used in a minimal infrastructure setting.
Figure 4: Two-way sensitivity analyses of adjusted life-years saved when antiretroviral therapy (ART) is scarce (5%).

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Acknowledgements

The authors thank T. Denny (UMDNJ–New Jersey Medical School, New Jersey, USA), S. A. Bozzette (RAND Corporation, California, USA), M. Urdea (Halteres Associates LLC, California, USA), P. Musoke (Makerere University, Kampala, Uganda), T. M. Meyers (Chris Hani Baragwanath Hospital, Soweto, South Africa) and D. M. Gibb (Medical Research Council Clinical Trials Unit, London, UK).

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Authors and Affiliations

  1. RAND Corporation, PO Box 2138, 1776 Main Street, Santa Monica, 90407-2138, California, USA

    Julia E. Aledort, Maria E. Rafael & Molly V. Shea

  2. National Coordinating Center for Infectious Diseases, 403-445 Ellice Avenue, Winnipeg, R3B3P5, Manitoba, Canada

    Allan Ronald

  3. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 60 Haven Avenue B1, New York, 10032, USA

    Sylvie M. Le Blancq

  4. Bill & Melinda Gates Foundation, PO Box 23350, Seattle, 98102, Washington, USA

    Renee Ridzon & Nicholas Hellmann

  5. Rush Presbyterian–St. Luke's Medical Center, 1735 West Harrison Street, Suite 616, Chicago, 60612, Illinois, USA

    Alan Landay

  6. Elizabeth Glaser Pediatric AIDS Foundation, 2950 31st Street, Suite 125, Santa Monica, 90405, California, USA

    Jeff Safrit & Cathy Wilfert

  7. World Health Organization, 20 Avenue Appia, Geneva 27, CH-1211, Switzerland

    Rosanna W. Peeling

  8. Department of Medicine, University of Zambia School of Medicine, PO Box 50110, Lusaka, Zambia

    Peter Mwaba

  9. Center for AIDS and STDs, Harborview Medical Center, University of Washington, Box 359931, 325 9th Avenue, Seattle, 98104, Washington, USA

    King Holmes

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Correspondence to Julia E. Aledort.

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Aledort, J., Ronald, A., Le Blancq, S. et al. Reducing the burden of HIV/AIDS in infants: the contribution of improved diagnostics. Nature 444 (Suppl 1), 19–28 (2006). https://doi.org/10.1038/nature05443

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