Challenges in the Early Diagnosis of HIV Infection in Infants: Experience from Tamil Nadu, India.

OBJECTIVE: To analyze critical steps in the testing algorithm of the National Early Infant Diagnosis (EID) program in India. METHODS: A retrospective analysis of data on cases enrolled in the EID program during 2010-2012 from Tamil Nadu was undertaken. RESULTS: 2745 dried blood spots were tested; 9% of these tested positive. Median age of infants at the time of testing was 4 months. Second specimen for confirmation was received from 67% of cases with a turn-around time of 10-270 days. CONCLUSIONS: Even with high levels of uptake into the program, huge delays and loss-to-follow-up observed between the first and second sampling, suggests need for revision of the current testing algorithm.