Follow-up of infants diagnosed with HIV -- Early Infant Diagnosis Program Francistown Botswana 2005-2012.

The 2011 prevalence of human immunodeficiency virus (HIV) among pregnant women in Botswana was 30.4%. High coverage rates of HIV testing and antiretroviral prophylaxis have reduced the rate of mother-to-child transmission of HIV in Botswana from as high as 40% with no prophylaxis to <4% in 2011. In June 2005 the national Early Infant Diagnosis (EID) Program began testing HIV-exposed infants (i.e. those born to HIV-infected mothers) for HIV using polymerase chain reaction (PCR) at 6 weeks postpartum. During 2005-2012 follow-up of all HIV-infected infants diagnosed in all 13 postnatal care facilities in Francistown Botswana was conducted to ascertain patient outcomes. A total of 202 infants were diagnosed with HIV. As of September 2013 82 (41%) children were alive and on antiretroviral therapy (ART) 79 (39%) had died and 41 (20%) were either lost to follow-up had transferred or their mothers declined ART. Despite success in preventing mother-to-child transmission in Botswana results of the EID program highlight the need for early diagnosis of HIV-infected infants prompt initiation of ART and retention in care. (Excerpt)