Evaluating the Utility of Loop-Mediated Isothermal Amplification (LAMP) for Point-of-Care HIV Early Infant Diagnosis in Rural Akwa Ibom State

Early infant diagnosis (EID) of HIV is critical for initiating antiretroviral therapy (ART) in HIV-exposed neonates before disease progression. Conventional PCR-based EID requires centralized laboratory infrastructure that is inaccessible to rural communities. Loop-mediated isothermal amplification (LAMP) offers a simpler, electricity-independent nucleic acid amplification option suitable for point-of-care (POC) deployment. This study evaluated the utility of LAMP for HIV EID among HIV-exposed infants attending rural health facilities in three local government areas of Akwa Ibom State, South-South Nigeria. Dried blood spot (DBS) samples from 120 HIV-exposed infants aged 6-8 weeks were tested in parallel with the RT-LAMP assay and the gold-standard Roche CAP/CTM HIV-1 Qualitative PCR. Sensitivity, specificity, and concordance with the reference standard were calculated. LAMP demonstrated sensitivity of 93.8% and specificity of 98.1% compared to the reference PCR method. The overall positive percent agreement was 93.8% and negative percent agreement 98.1%. Twelve samples yielded indeterminate LAMP results requiring repeat testing. The LAMP platform was operable on dry-cell battery power and required minimal training, with turnaround time under 90 minutes. These findings support LAMP as a viable POC EID option for resource-constrained rural communities in Akwa Ibom State. Keywords: LAMP, HIV early infant diagnosis, point-of-care, dried blood spot, Akwa Ibom State.