Improving HIV diagnosis in Myanmar

Burnet Institute

14 November, 2018

The GeneXpert machine tests for HIV viral load, a strong predictor of the rate of disease progression

The impact of HIV on infant morbidity and mortality in Myanmar could be significantly reduced by the introduction of point-of-care GeneXpert early infant diagnosis (EID) testing in local hospitals, a collaborative Burnet study has found.

HIV contributes significantly to maternal and infant deaths in Myanmar, where an estimated 15 percent of infants exposed to HIV become infected.

Early infant diagnosis and timely treatment with antiretrovirals have been shown to reduce morbidity and mortality, but currently less than 50 percent of HIV-exposed infants receive a diagnostic virology test in their first eight weeks of life.

Policies in Myanmar recommend that HIV-exposed infants are tested at four-to-six weeks of age and at birth, if feasible, using dried blood spots sent to centralised laboratories.

The Burnet study found that point-of-care GeneXpert tests introduced at four public hospitals in Yangon between November 2016 and June 2018 were far more beneficial than the standard laboratory tests.

By three months of age, 81.8 percent of participants in the GeneXpert group had received a test result, compared to 3.9 percent of those in standard care.

Over the first six months of age, HIV-exposed infants tested with the Xpert were 3.86 times more likely to receive an EID result, and 63 percent quicker, than those in standard care.

Lead researcher, Burnet Women’s and Children’s Health Specialist, Associate Professor Stanley Luchters said some barriers to the introduction of GeneXpert testing, including limited clinic space, electricity disruption and increased workload, would need to be addressed.

But he said caregivers appreciated the benefits of having access to accurate, same-day results.

“This service helps to relieve stress and by facilitating communication between staff and patients, has a positive influence on patient retention and follow-up,” Associate Professor Luchters said.

The Director General of Myanmar’s National Health Laboratory, Professor Htay Htay Tin, said the convenience of the GeneXpert test could have a huge impact.

“A GeneXpert device set up at a facility where a trained technician is available … will definitely reduce the rate of HIV infection,” he said.

Burnet Institute Country Program Manager for Myanmar, Lia Burns said the study has important policy implications for the HIV response in Myanmar.

“Burnet is committed to continuing our contribution to this important work,” Ms Burns said.

This study was conducted in collaboration with the Myanmar National Health Laboratory, the National AIDS Program, and the Kirby Institute.

Find out more about Burnet’s work in Myanmar.

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