21 November 2013

Earlier Aids testing needed for high-risk children

More than a quarter of a million children each year are born infected with the virus that causes Aids, but too few are being tested early to receive treatment.

More than a quarter of a million children each year are born infected with the virus that causes Aids, but too few are being tested early to receive treatment and prolong their lives, the United Nations said.

Michele Sidibe, executive director of UNAIDS, called for diagnostic kits to be improved for detection in babies of the Human Immunodeficiency Virus (HIV) that causes Aids, and for their "still high" current price of R254 - R508 to be brought down.

Children are the "forgotten" victims of the Aids epidemic, yet 260 000 babies joined their ranks last year, mainly in sub-Saharan Africa, he said.

"Irrespective of the market size we need to make sure that diagnostics are made available for children," he told a news conference in Geneva ahead of World Aids Day on December 1.

"We made a lot of progress during the last 2 - 3 years in terms of treatment, in terms of medicines, in terms of making sure that the molecules are more well-targeted for children. But where we are failing is also making early diagnostics."

US based Abbott Laboratories and Swiss drugmaker Roche are among the main manufacturers of HIV diagnostics, according to senior UNAIDS officials.

Some 3.3 million children under age 15 have HIV, but only 1.9 million of them require treatment today, according to the Geneva-based agency. Fewer than 650 000 or 34% of the 1.9 million received antiretroviral Aids drugs in 2012, still a rise of 14% from the year before, it said.

Some 14 million adults with HIV need treatment, and 9 million of them or 64% are receiving it, a far higher coverage rate than for children.

Priority countries

UNAIDS has identified 22 priority countries for stopping infections in children, 21 of them in sub-Saharan Africa, home to 90% of women living with HIV. The other is India.

In three of these priority countries Chad, Democratic Republic of Congo and Malawi – fewer than 5% of infants at risk are being tested for HIV at birth, UNAIDS says.

"In priority countries, only 3 in 10 children receive HIV treatment. We have seen tremendous political commitment and results to reduce mother-to-child transmission but we are failing the children who become infected," said Sidibe, who is from Mali.

All children under five who test positive for the virus should be put on treatment, according to Mahesh Mahalingam, UNAIDS director for its global plan for stopping new infections in children.

Current PCR tests are able to detect the virus in a baby only after the age of six weeks and require sending a blood sample to a specialised laboratory, he said.

"What we looking for are easier tests that we can administer earlier on, this will help detect the virus and start them on medicines faster. We recommend that as soon as the child is known to be HIV positive, you start on antiretroviral drugs," Mahalingam told Reuters.

He added: "The earlier we can diagnose, the earlier we can treat them which increase chances of child survival. Children are now getting to grow into adults. If we start pretty early they have the same chance of living as any other children."


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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