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. 2024 Mar 18;25(1):1542.
doi: 10.4102/sajhivmed.v25i1.1542. eCollection 2024.

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

Hendrike van Vollenhoven  1 , Emma Kalk  2 , Stuart M Kroon  1 , Tafadzwa Maseko  3 , Florence Phelanyane  4 , Jonathan Euvrard  4 , Lezanne Fourie  5 , Nicolene le Roux  6 , Phumza Nongena  1
Affiliations

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

Hendrike van Vollenhoven et al. South Afr J HIV Med. .

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

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Sub-analysis of infants who did not have 10-week HIV PCR testing.
See this image and copyright information in PMC

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