Original Research

Effects of the COVID-19 pandemic on early infant diagnosis of HIV in Cape Town, South Africa

Hendrike van Vollenhoven, Emma Kalk, Stuart M. Kroon, Tafadzwa Maseko, Florence Phelanyane, Jonathan Euvrard, Lezanne Fourie, Nicolene le Roux, Phumza Nongena
Southern African Journal of HIV Medicine | Vol 25, No 1 | a1542 | DOI: https://doi.org/10.4102/sajhivmed.v25i1.1542 | © 2024 Hendrike van Vollenhoven, Emma Kalk, Stuart M. Kroon, Tafadzwa Maseko, Florence Phelanyane, Jonathan Euvrard, Lezanne Fourie, Nicolene le Roux, Phumza Nongena | This work is licensed under CC Attribution 4.0
Submitted: 06 October 2023 | Published: 18 March 2024

About the author(s)

Hendrike van Vollenhoven, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Emma Kalk, School of Public Health, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
Stuart M. Kroon, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Tafadzwa Maseko, Family Medicine and Population Health (FAMPOP), Department of Epidemiology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
Florence Phelanyane, Health Intelligence Directorate, Western Cape Department of Health, Cape Town, South Africa
Jonathan Euvrard, Health Intelligence Directorate, Western Cape Department of Health, Cape Town, South Africa
Lezanne Fourie, Department of Neonatology, Mowbray Maternity Hospital, Cape Town, South Africa
Nicolene le Roux, HIV/AIDS, STI’s and Tuberculosis Directorate (HAST), New Somerset Hospital, Cape Town, South Africa
Phumza Nongena, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa

Abstract

Background: In South Africa, infants who are HIV-exposed are tested for HIV at birth and 10 weeks of age. The COVID-19 pandemic lockdown restrictions resulted in reduced access to healthcare services and uncertain impact on early infant HIV testing.

Objectives: To describe the effects of the COVID-19 pandemic lockdown restrictions on early infant HIV testing and diagnosis in Cape Town, South Africa.

Method: This retrospective cohort study compares HIV-exposed infants born during the first COVID-19 pandemic lockdown (2020) to those born in the same period the year before (2019). Laboratory and other data were abstracted from the Provincial Health Data Centre.

Results: A total of 2888 infants were included: 1474 born in 2020 and 1413 in 2019. Compared to 2019, there was an increase in the 10-week HIV polymerase chain reaction (PCR) uptake in 2020 (71% vs. 60%, P < 0.001). There was also an increase in the proportion of infants who demised without 10-week testing or were lost to follow-up in 2020 compared to 2019 (8% vs. 5%, P = 0.017). Differences detected in birth HIV PCR positivity rates between the two groups (1.1% vs. 0.5%, P = 0.17) did not reach statistical significance; however, a significant increase in vertical transmission of HIV by 10 weeks old was found in the 2020 cohort (1.2% vs. 0.5%. P = 0.046).

Conclusion: Vertical transmission of HIV at 10 weeks increased in the Cape Town Metropolitan during the initial COVID-19 lockdown. There was also an increase in the proportion of deaths without testing by 10 weeks in the 2020 group.


Keywords

vertical transmission prevention; VTP; HIV; COVID-19; early infant diagnosis; vertical transmission; prevention of mother-to-child transmission; PMTCT.

Sustainable Development Goal

Goal 3: Good health and well-being

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