The Journal of infection
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The Journal of infection · Nov 2014
ReviewMother to child transmission of HIV: what works and how much is enough?
In 2012, 3.3 million children were living with HIV (Human Immunodeficiency virus), of whom 260,000 were new infections. Prevention of mother to child transmission is vital in reducing HIV-related child mortality and morbidity. With intervention the risk of transmission can be as low as 1% and without it, as high as 45%. ⋯ Where resources are not limited an individualised approach can be adopted. Worldwide, health care needs to be accessible and HIV testing performed in pregnancy and followed up in a robust but socially sensitive way so that treatment can be initiated appropriately. In either setting the risk of transmission is never zero and countries need to decide for themselves what is the most practical and sustainable approach for their setting, so that the maximum impact on maternal and child mortality and morbidity can be achieved.
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The Journal of infection · Nov 2014
ReviewHost RNA signatures for diagnostics: an example from paediatric tuberculosis in Africa.
Host gene expression profiling is a widely used research tool for assessing the host response to infection in order to provide insight into the immunopathophysiology of disease, as well as the analysis of disease progression and treatment response. It has recently been applied for the diagnosis of tuberculosis in children in Africa, as a result of the implementation of novel statistical methodology that enabled the reduction of a large number of significantly differentially expressed genes into a minimal set, and the development of a 'disease risk score' that could be used to develop a diagnostic test. Whilst the experimental and statistical methodologies are now in place to generate minimal transcriptional signatures that can distinguish disease states, the challenge is how to take these forward into development of a diagnostic test for use in clinical resource-poor settings.