Discordant rapid HIV tests: lessons from a low-resource community
| Autor: | Achiaka E. Irabor, E. A. Solanke, Onoja Akpa, Babafemi Taiwo, M. Imhansoloeva, O. A. Mosuro, Isaac F. Adewole, Baiba Berzins, R. A. Audu, Sufiyan A. Muyibi, Modupe Kuti, Adesola Ogunniyi, Kevin Robertson, Adedotun A. Adetunji, M. M. A. Ladipo |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 0301 basic medicine Malawi medicine.medical_specialty Adolescent HIV Antigens Low resource 030106 microbiology Human immunodeficiency virus (HIV) HIV Infections HIV Antibodies medicine.disease_cause Article Young Adult 03 medical and health sciences 0302 clinical medicine Unsafe Sex Internal medicine medicine Humans Pharmacology (medical) 030212 general & internal medicine Aged Aged 80 and over Immunoassay Acute HIV infection biology Diagnostic Tests Routine business.industry Health Policy Reproducibility of Results virus diseases Odds ratio Middle Aged Virology Confidence interval Cross-Sectional Studies Infectious Diseases HIV-1 biology.protein Female Test performance Antibody business |
| Zdroj: | HIV Medicine. 19:72-76 |
| ISSN: | 1464-2662 |
| DOI: | 10.1111/hiv.12541 |
| Popis: | ObjectivesHIV rapid antibody tests are widely used in Africa, but dual testing sometimes produces discordant results. It is not clear if discordant rapid HIV tests should always heighten suspicion by frontline health workers that early HIV infection is present. Some studies have reported that discordant rapid tests have value for identifying early HIV infection in high HIV prevalence populations. It is not known if rapid test performance influenced this conclusion, or if this observation will hold true for low HIV prevalence populations. We therefore explored the occurrence of discordant rapid HIV tests in a low-resource community.MethodsA cross-sectional sample of HIV status-unaware adults with recent exposure to unsafe sex was assessed using a validated risk-based tool (University of North Carolina (UNC)-Malawi Risk Screening Score) for acute HIV infection. Participants received rapid testing with Determine HIV 1/2 and Uni-Gold HIV assays, plus plasma HIV-1 antigen testing with the COBAS((R)) Ampliprep/COBAS((R)) Taqman((R)) HIV-1 assay, followed by western blot in those with detected HIV-1 antigen.ResultsOf 408 participants, 1.0% were confirmed to have established HIV infection. The discordance between rapid tests at initial screening was 2.45 and 2.94% when the two assays were used sequentially and simultaneously, respectively. Discordant rapid tests were strongly associated with risk scores > 2 [odds ratio (OR) 10.88; 95% confidence interval (CI) 2.35-50.43], and with detected HIV-1 RNA (OR 26.06; 95% CI 3.91-173.60).ConclusionsWhen the sample occurrence of discordance between the first and second tests is below 5%, discordant rapid tests in an adult with sexual risk behaviour should trigger strong suspicion of early HIV infection in low HIV prevalence populations. |
| Databáze: | OpenAIRE |
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