The Performance of 5 Rapid HIV Tests Using Whole Blood in Infants and Children
| Autor: | Rivka R. Lilian, Ashraf Coovadia, Gayle G. Sherman |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Microbiology (medical) Pediatrics medicine.medical_specialty Time Factors Cross-sectional study HIV exposure Population Human immunodeficiency virus (HIV) HIV Infections medicine.disease_cause Sensitivity and Specificity South Africa medicine Humans Child education Whole blood education.field_of_study Clinical Laboratory Techniques business.industry Infant Newborn Infant virus diseases Early infancy Confidence interval Test (assessment) Blood Cross-Sectional Studies Infectious Diseases Child Preschool Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Pediatric Infectious Disease Journal. 31:267-272 |
| ISSN: | 0891-3668 |
| Popis: | BACKGROUND: Rapid tests have the potential to improve the identification of HIV-infected children in resource-limited settings. However they remain underutilized because of a lack of data on their performance in the field using whole blood specimens. This study aimed to assess the accuracy of rapid tests for detecting HIV exposure excluding HIV infection in HIV-exposed infants and diagnosing HIV infection in children older than 18 months of age. METHODS: Five rapid tests (First Response Pareekshak Determine Smart Check and Insti) were performed using whole blood from children enrolled in a multisite cross-sectional study in South Africa. HIV enzyme-linked immunosorbent assay and DNA polymerase chain reaction results defined HIV exposure and infection respectively and were the standards used for comparison. RESULTS: Of the 851 children enrolled 186 (21.9%) were infected with HIV. For detecting HIV exposure Determine demonstrated the highest sensitivity of 99.3% (95% confidence interval 98.0-99.8) in early infancy but sensitivity declined with age as seroreversion occurred. After 8 months of age all tests except First Response excluded HIV infection in 82% to 100% of HIV-uninfected infants and in conjunction with a clinical assessment did not miss any HIV-infected children. Insti was the only test that detected all HIV-infected infants albeit on the smallest number of samples. The performance of all rapid tests in children older than 18 months of age was similar to that in adults. CONCLUSIONS: Determine was the only rapid test that had a high enough sensitivity for detecting HIV exposure in early infancy but it identified seroreversion later in life than the other tests. Insti warrants further investigation for both indications. |
| Databáze: | OpenAIRE |
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