Rapid HIV diagnostic test in undocumented pregnant women applied at an inner-city teaching hospital

A significant number of Brazilian gestational-age women are still not tested for HIV, representing a high risk of transmission to their newborns. The current study sought to identify the number of pregnant women with no previous testing or undocumented for HIV referred to the Gynecology and Obstetrics Department of a Regional Teaching Hospital and included diagnosis of HIV infection determined by a rapid test and perinatal transmission in pregnancy. Medical records of all pregnant women admitted to hospital from January 2001 to December 2005 were reviewed. Pregnant women without HIV results were submitted to a rapid HIV test. Those who tested positive were further tested by ELISA and confirmed by indirect immunofluorescence assay (IIA) or Western blot (WB). The viral load from babies born to HIV-infected mothers was assessed by bDNA. Of the 16,424 pregnant women analyzed (6.6%), 1,089 were undocumented for HIV. Eleven women were positive in rapid testing and 10 were confirmed by ELISA, IIA or WB, with 0.9% seropositivity. Mother/infant pairs received zidovudine monotherapy prophylaxis and infant viral load was lower than 50 copies/mL. A higher number of pregnant women previously tested for HIV during antenatal care was verified, compared to that obtained nationwide.

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Evaluation of antenatal rapid human immunodeficiency virus testing in rural South Africa

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v19i1.771 ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Tivani P. Mashamba-Thompson ◽

Pravi Moodley ◽

Benn Sartorius ◽

Paul K. Drain

Keyword(s):

Pregnant Women ◽

Hiv Testing ◽

Rapid Test ◽

Test Results ◽

Rapid Testing ◽

Hiv Test ◽

Hiv Rapid Testing ◽

Immunodeficiency Virus ◽

Rapid Tests ◽

Testing Algorithm

Introduction: South African guidelines recommend two rapid tests for diagnosing human immunodeficiency virus (HIV) using the serial HIV testing algorithm, but the accuracy and compliance to this algorithm is unknown in rural clinics. We evaluated the accuracy of HIV rapid testing and the time to receiving test results among pregnant women in rural KwaZulu-Natal (KZN).Method: We observed the accuracy of rapid HIV testing algorithms for 208 consenting antenatal patients accessing voluntary HIV testing services in nine rural primary healthcare (PHC) clinics in KZN. A PHC-based HIV counsellor obtained finger-prick whole blood from each participant to perform rapid testing using the Advanced Quality™ One Step anti-HIV (1&2) and/or ABON™ HIV 1/2/O Tri-Line HIV test. A research nurse obtained venous blood for an enzyme-linked immunosorbent assay (ELISA) HIV test, which is the gold standard diagnostic test. We recorded the time of receipt of HIV test results for each test.Results: Among 208 pregnant women with a mean age of 26 years, 72 women from nine rural PHC clinics were identified as HIV-positive by two rapid tests with an HIV-prevalence of 35% (95% Bayesian credibility intervals [BCI]: 28% – 41%). Of the 208 patients, 135 patients from six clinics were tested with the serial HIV testing algorithm. The estimated sensitivity and specificity for the 135 participants were 100% (95% confidence interval [CI]: 93% – 100%) and 99% (CI: 95% – 100%), respectively. The positive predictive value and negative predictive value were estimated at 98% (CI: 94% – 100%) and 95% (CI: 88% – 99%), respectively. All women received their HIV rapid test results within 20 min of testing. Test stock-out resulted in poor test availability at point-of-care, preventing performance of a second HIV test in three out of nine PHC clinics in rural KZN.Conclusion: Despite the poor compliance with national guidelines for HIV rapid testing services, HIV rapid test results provided to pregnant women in rural PHC clinics in KZN were generally accurate and timely. Test stock-out was shown to be one of the barriers to test availability in rural PHC clinics, resulting in poor compliance with guidelines. We recommend a compulsory confirmation HIV rapid test for all HIV-negative test results obtained from pregnant patients in rural and resource-limited settings.

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Linkage between H. pylori Infection and TNF-α polymorphism in The Pregnant Women

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v9ispl1.1298 ◽

2018 ◽

Vol 9 (SPL1) ◽

Author(s):

Ghaidaa Raheem Lateef ◽

Azhar Omaran Al-Thahab

Keyword(s):

Pregnant Women ◽

Serum Antibody ◽

Rapid Test ◽

Negative Group ◽

Positive Group ◽

Gynecology And Obstetrics ◽

Tnf Α ◽

Significant Difference ◽

Pcr Products ◽

H Pylori

A study was performed on 100 pregnant women in the outpatient department of gynecology and obstetrics of Maternity and Children Hospital in Al-Diwaniya City during the period between (March to September 2016). One hundred blood samples (50 for patients and 50 for control) were collected under the supervision of the treating gynecologist. The detection of Helicobacter. pylori was done by the use of the serum antibody Rapid test. The results showed that 50 (100%) were positive and 50 (100%) were negative for H. pylori in above method.All blood of patients and control samples were used for the extraction of genomic DNA,where the 107 bp PCR product size. Genotyping of the TNF-α-308 SNP (G/A)was performed by restriction fragment length polymorphism PCR (RFLP-PCR). PCR products were digested with restr NcoI iction enzyme. Individuals with the TNF-α-308(GG) homozygote produced digested DNA bands at 80,and 20 bp bp. A heterozygous genotype ofTNF-α-308 (GA)produced 107 bp,80 bp,and 20 bp bands. Individuals with the TNF-α-308 (AA) homozygote genotype had no amplicon digested and generated only one band of 107 bp. There was a significant difference in the frequency of the TNF-α-308(GG)genotype between H. pylori positive group and H. pylori negative group(72%,78% respectively). Also for GA genotype,there was a significant difference between H. pylori positive group and H. pylori negative group(24%,18% respectively). Concerning the frequency of the TNF-α-308 (AA)genotype between H. pylori positive group and H. pylori negative group,there was no significant difference between the two groups.

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Low Rate of False-Positive Results with Use of A Rapid HIV Test

Infection Control and Hospital Epidemiology ◽

10.1086/502061 ◽

2002 ◽

Vol 23 (6) ◽

pp. 335-337 ◽

Cited By ~ 10

Author(s):

Cassandra D. Salgado ◽

Heidi L. Flanagan ◽

Doris M. Haverstick ◽

Barry M. Farr

Keyword(s):

Enzyme Immunoassay ◽

False Positive ◽

Diagnostic System ◽

Rapid Test ◽

Occupational Exposures ◽

High Rate ◽

Negative Results ◽

Hiv Test ◽

Rapid Hiv Test ◽

Positive Results

Background:Occupational exposure to human immunodeficiency virus (HIV) is an important threat to healthcare workers. Centers for Disease Control and Prevention guidelines recommend prompt institution of prophylaxis. This requires (1) immediate prophylaxis after exposure, pending test results that may take more than 24 hours in many hospitals; or (2) performance of a rapid test. The Single Use Diagnostic System (SUDS)® HIV-1 Test is used to screen rapidly for antibodies to HIV type 1 in plasma or serum, with a reported sensitivity of more than 99.9%. We used this test from January 1999 until September 2000, when it was withdrawn from the market following reports claiming a high rate of false-positive results.Methods:We reviewed the results of postexposure HIV testing during 21 months.Results:A total of 884 SUDS tests were performed on source patients after occupational exposures (883 negative results, 1 reactive result). The results of repeat SUDS testing on the reactive specimen were also reactive, but the results of enzyme immunoassay and Western blot testing were negative. A new specimen from the same patient showed a negative result on SUDS testing. This suggested a specificity of 99.9%. In the 4 months after SUDS testing was suspended, there was 1 false-positive result on enzyme immunoassay for 1 of 132 source patients (presumed specificity, 99.2%).Conclusion:Use of the SUDS test facilitated rapid and accurate evaluation of source specimens, obviating unnecessary prophylaxis.

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Análise da operacionalização da testagem rápida para o HIV realizada pelo enfermeiro

Revista Recien - Revista Científica de Enfermagem ◽

10.24276/rrecien2358-3088.2020.10.29.100-111 ◽

2020 ◽

Vol 10 (29) ◽

pp. 100-111

Author(s):

Ilisdayne Thallita Soares da Silva ◽

Dhyanine Morais de Lima ◽

Wenysson Noleto dos Santos ◽

Rebecca Stefany da Costa Santos ◽

Harlon França de Menezes ◽

...

Keyword(s):

Family Health ◽

Rapid Test ◽

Structured Interview ◽

Reference Network ◽

Health Strategy ◽

Hiv Test ◽

Rapid Hiv Test ◽

Family Health Strategy ◽

La Red ◽

Anti Hiv

O estudo objetivou analisar os modos de operacionalização da testagem rápida para o HIV realizada pelo Enfermeiro na Estratégia Saúde da Família. Trata-se de estudo qualitativo com 13 Enfermeiros da Estratégia Saúde da Família da Paraíba. Os dados foram coletados de abril a junho de 2017 por meio de entrevista semiestruturada e analisados pela análise temática de Bardin e o fluxograma descritor. As categorias que emergiram a partir das entrevistas e agrupadas em etapas no fluxograma descritor foram: oferta do teste rápido anti-HIV; entrega do resultado e aconselhamento pré-teste; execução do teste rápido anti-HIV; aconselhamento pós-teste; e encaminhamento do paciente. Conclui-se que a necessidade da identificação do fornecimento adequado de kits de testagem, da ampliação da oferta do teste para a população em geral, e da interação entre as unidades e Rede de referência no Estado.Descritores: Enfermagem, Testes Sorológicos, Síndrome de Imunodeficiência Adquirida. Analysis of the operationalization of the rapid test for HIV carried out by the nurseAbstract: The aim of this study was to analyze the ways in which the nurse performed rapid testing for HIV in the Family Health Strategy. This is a qualitative study with 13 Nurses of the Paraíba Family Health Strategy. The data were collected from April to June 2017 through a semi-structured interview and analyzed by the thematic analysis of Bardin and the flowchart descriptor. The categories that emerged from the interviews and were grouped in stages in the flowchart descriptor were: rapid HIV test offer, delivery of the result and pre-test counseling; implementation of the rapid HIV test; post-test counseling; and patient referral. It is concluded that the need to identify the adequate supply of test kits, the expansion of the test offer to the general population, and the interaction between the units and reference network in the State.Descriptors: Nursing, Serologic Tests, Acquired Immunodeficiency Syndrome. Análisis de la operacionalización de la prueba rápida para el HIV realizado por el enfermeroResumen: El estudio objetivó analizar las formas de operacionalización de las pruebas rápidas para el HIV realizada por el enfermero en la Estrategia de Salud Familiar. Este es un estudio cualitativo con 13 enfermeras de la Estrategia de Salud Familiar de Paraíba. Los datos se recopilaron de abril a junio de 2017 a través de una entrevista semiestructurada y se analizaron mediante el análisis temático de Bardin y el flujograma descriptor. Las categorías que surgieron de las entrevistas y se agruparon en etapas en el flujograma descriptor fueron: oferta de prueba rápida de anti-HIV, entrega del resultado y asesoramiento previo a la prueba; ejecución de la prueba rápida de HIV; asesoramiento posterior a la prueba; y encaminamiento del paciente. Se concluye que la necesidad de identificar el suministro adecuado de kits de prueba, la expansión de la oferta de prueba a la población general y la interacción entre las unidades y la Red de referencia en el Estado.Descriptores: Enfermería, Pruebas Serológicas, Síndrome de Inmunodeficiencia Adquirida.

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Hepatitis B e Antigen (HBeAg) Rapid Test and Alanine Aminotransferase Level–Based Algorithm to Identify Pregnant Women at Risk of HBV Mother-to-Child Transmission: The ANRS 12345 TA PROHM Study

Clinical Infectious Diseases ◽

10.1093/cid/ciaa282 ◽

2020 ◽

Vol 71 (10) ◽

pp. e587-e593 ◽

Cited By ~ 1

Author(s):

Olivier Segeral ◽

Bunnet Dim ◽

Christine Durier ◽

Sophearot Prak ◽

Kearena Chhim ◽

...

Keyword(s):

At Risk ◽

Hepatitis B ◽

Pregnant Women ◽

Sensitivity And Specificity ◽

Alanine Aminotransferase ◽

Rapid Test ◽

Perinatal Transmission ◽

Hbv Dna ◽

Dna Quantification ◽

Low Middle Income Countries

Abstract Background The paucity of hepatitis B virus (HBV) DNA measurement in low-/middle-income countries hinders the identification of HBV-infected pregnant women at risk of perinatal transmission. This study evaluates the validity of an algorithm selecting HBeAg-positive women and HBeAg-negative women with alanine aminotransferase (ALT) ≥40 IU/L as a predictor of high HBV DNA level. Methods All women with reactive samples for hepatitis B surface antigen (HBsAg) were assessed with an SD BIOLINE HBeAg rapid test and HBV DNA quantification was performed. Validities of HBeAg and of the algorithm to identify HBV DNA >2 thresholds (5.3 and 7.3 log10 IU/mL) were evaluated. Results For the 515 HBsAg-positive women, median age was 29 years, 92 (17.9%) were HBeAg positive, 47 (9.1%) were HBeAg negative with ALT ≥40 IU/L, and 144 (28.0%) had an HBV DNA >5.3 log10 IU/mL. Sensitivity and specificity of HBeAg were 61.8% and 99.2% for HBV DNA >5.3 log10 IU/mL and 81.3% and 96.7% for HBV DNA >7.3 log10 IU/mL. For the algorithm, sensitivity and specificity were 79.2% and 93.3% for HBV DNA level >5.3 log10 IU/mL and 92.7% and 88.1% for HBV DNA >7.3 log10 IU/mL. The AUCs for the algorithm (0.92 and 0.94 for HBV DNA >5.3 and 7.3, respectively) were significantly greater (P < .001) than the AUCs for HBeAg (0.81 and 0.89 for HBV DNA >5.3 and 7.3, respectively). Conclusions An algorithm using HBeAg and ALT level could be an effective strategy to identify HBV-infected pregnant women at risk of perinatal transmission in countries where HBV DNA quantification is not routinely available.

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Strengths and weaknesses of rapid hiv test implementation in a specialized center in Brazil

Revista de Salud Pública ◽

10.15446/rsap.v20n5.61336 ◽

2018 ◽

Vol 20 (5) ◽

pp. 560-567

Author(s):

Adolfo Pizzinato ◽

Kátia Bones Rocha ◽

Rodrigo De Oliveira-Machado ◽

Fernanda Torres de Carvalho ◽

Isadora Nogueira-Freire

Keyword(s):

Health Care ◽

Hiv Testing ◽

Health Care Access ◽

Health Care Professionals ◽

Rapid Test ◽

Service Users ◽

Structured Interviews ◽

Rapid Hiv Testing ◽

Hiv Test ◽

Rapid Hiv Test

Objective To analyze how health professionals and health service users assess counseling on Rapid HIV test, as well as its implementation, which started in Brazil in 2010, focusing on positive aspects, barriers, and limitations, and analyzing possible meanings that are given to STD and HIV/AIDS.Method Qualitative, exploratory, and descriptive research. Semi-structured interviews were administered to 27 service users and 14 health care professionals; a thematic analysis of the interviews was performed. The study was carried out in one of the first Counseling and Testing Centers (CTC) designed to implement Rapid HIV tests in Porto Alegre, Brazil.Results Positive aspects of Rapid HIV testing implementation included a reduced waiting time for obtaining the test results, better assistance provision, an increase in the number of service hours, personalized pre- and post-tests, and better prepared health care professionals regarding health care during counseling. Limitations included beliefs about the effectiveness of Rapid HIV testing, physical structure, bad publicity on this technology, and poor health care capacity. Likewise, there are some who oppose this type of test, since they believe rapid tests may not be effective.Conclusions Integrating the perspectives of health care professionals and users on this policy will favor future rapid test implementations in other CTCs, and increase health care access possibilities.

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Efficacy and safety of lamivudine treatment in late pregnancy with high HBV DNA: a perspective for mother and infants

The Journal of Infection in Developing Countries ◽

10.3855/jidc.1398 ◽

2011 ◽

Vol 5 (04) ◽

pp. 303-306 ◽

Cited By ~ 18

Author(s):

Sükran Köse ◽

Melda Türken ◽

İlker Devrim ◽

Cüneyt Taner

Keyword(s):

Viral Load ◽

Hepatitis B ◽

Adverse Effects ◽

Pregnant Women ◽

High Viral Load ◽

Perinatal Transmission ◽

Hbv Dna ◽

Efficacy And Safety ◽

Lamivudine Treatment ◽

Lamivudine Therapy

Introduction: Perinatal transmission - from mother to fetus - is one of the main transmission routes of chronic hepatitis B (CHB) infection. Lamivudine therapy has been reported to prevent the replication of hepatitis B virus (HBV) in pregnant women with a high viral load that can lead to perinatal transmission. Methodology: This study sought to evaluate retrospectively the efficacy and safety of lamivudine treatment in pregnant women with CHB and a high viral load. Biochemical parameters, and virological and serological responses at the 32nd and 36th week of gestation and after labor were recorded. The complications of CHB and the adverse effects of lamivudine treatment were also recorded. Results: Following 8 weeks of lamivudine treatment, HBV viral load decreased to levels ≤ 10,000 copies/ml in five of the seven patients (71%) and in three patients (43%), HBV DNA was found to be completely negative after labor. Neither adverse effects caused by lamivudine treatment nor complications due to CHB infection were experienced by mothers or infants. Conclusions: The results of this study suggest that lamivudine therapy in highly viremic hepatitis B surface antigen (HBsAg)-positive pregnant women could decrease perinatal transmission rates of HBV, and can lower the HBV viral load during labor.

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Performance of the nursing team in the rapid HIV tes

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963.2020.244420 ◽

2020 ◽

Vol 14 ◽

Author(s):

Lise Maria Carvalho Mendes ◽

Leidiane Pereira de Sousa ◽

Renata Simões Monteiro ◽

Veridiana Barreto do Nascimento ◽

Antonio Sabino da Silva Neto

Keyword(s):

Health Care ◽

Primary Health Care ◽

Rapid Test ◽

Hiv Infections ◽

Test Method ◽

Primary Health ◽

Hiv Test ◽

Rapid Hiv Test ◽

Nursing Team ◽

Anti Hiv

Objetivo: identificar potencialidades e fragilidades da equipe de enfermagem no manejo de pacientes no teste rápido anti-HIV. Método: trata-se de um estudo quantitativo, descritivo, exploratório, com a equipe de enfermagem que atua na execução do teste rápido anti-HIV. Levantou-se amostragem censitária, totalizando seis enfermeiros e seis técnicos de enfermagem os quais responderam ao questionário sociodemográfico e sobre a realização do teste rápido. Resultados: observaram-se, como potencialidades, a realização de grupos educativos, a realização do aconselhamento pós-teste e a entrega de resultados de forma individual. Verificaram-se as seguintes fragilidades: ficha imprópria para a coleta de dados; execução de etapas do teste rápido por profissionais distintos; ambiguidade na execução do protocolo de recrutamento de parceiros e notificação compulsória; sentir-se inseguro para a realização do procedimento; sobrecarga de trabalho; restrição de horários de funcionamento das Unidades Básicas de Saúde. Conclusão: ressalta-se que as fragilidades visualizadas demonstram que não se trata de uma problemática exclusiva à atenção PVHA na perspectiva da Atenção Primária à Saúde, mas, também, a outras ações programáticas no âmbito da Política Nacional da Atenção Básica. Descritores: HIV; Infecções por HIV; Síndrome da Imunodeficiência Adquirida; Equipe de Enfermagem; Atenção Primária à Saúde; Diagnóstico Precoce.AbstractObjective: to identify the nursing team's strengths and weaknesses in the management of patients in the rapid HIV test. Method: this is a quantitative, descriptive, exploratory study, with the nursing team that works on the rapid HIV test. A census sampling was carried out, totaling six nurses and six nursing technicians who answered the sociodemographic questionnaire and the performance of the rapid test. Results: it was observed, as potentialities, the realization of educational groups, the realization of post-test counseling and the delivery of results individually. The following weaknesses were found: improper form for data collection; execution of rapid test steps by different professionals; ambiguity in the execution of the partner recruitment protocol and mandatory notification; feeling insecure to perform the procedure; work overload; restriction of opening hours of the Basic Health Units. Conclusion: it is emphasized that the weaknesses seen demonstrate that this is not an exclusive problem to PLWHA care from the perspective of Primary Health Care, but also to other programmatic actions within the scope of the National Primary Care Policy. Descriptors: HIV; HIV Infections; Acquired Immunodeficiency Syndrome; Nursing, Team; Primary Health Care; Early Diagnosis.ResumenObjetivo: identificar las fortalezas y debilidades del equipo de enfermería en el manejo de pacientes en la prueba rápida de VIH. Método: es un estudio cuantitativo, descriptivo, exploratorio, con el equipo de enfermería que trabaja en la prueba rápida de VIH. Se realizó un muestreo censal, con un total de seis enfermeros y seis técnicos de enfermería que respondieron el cuestionario sociodemográfico y el desempeño de la prueba rápida. Resultados: se observó, como potencialidades, la realización de grupos educativos, la consejería posterior a la prueba y la entrega de resultados individualmente. Se encontraron las siguientes debilidades: forma incorrecta para la recopilación de datos; ejecución de pasos de prueba rápidos por diferentes profesionales; ambigüedad en la ejecución del protocolo de reclutamiento de socios y notificación obligatoria; sentirse inseguro para realizar el procedimiento; sobrecarga de trabajo; restricción de los horarios de atención de las Unidades Básicas de Salud. Conclusión: se enfatiza que las debilidades observadas demuestran que este no es un problema exclusivo para la atención de las PVVS desde la perspectiva de la Atención Primaria de Salud, sino también para otras acciones programáticas dentro del alcance de la Política Nacional de Atención Primaria. Descriptores: VIH; Infecciones por VIH; Síndrome de Inmunodeficiencia Adquirida; Grupo de Enfermeira; Atención Primaria de Salud; Diagnóstico Precoz.

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A Case Series of Third-Trimester Raltegravir Initiation: Impact on Maternal HIV-1 Viral Load and Obstetrical Outcomes

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2015/731043 ◽

2015 ◽

Vol 26 (3) ◽

pp. 145-150 ◽

Cited By ~ 6

Author(s):

I Boucoiran ◽

K Tulloch ◽

N Pick ◽

F Kakkar ◽

J van Schalkwyk ◽

...

Keyword(s):

Viral Load ◽

Caesarean Section ◽

Pregnant Women ◽

Case Series ◽

Perinatal Transmission ◽

University Hospital ◽

Perinatal Hiv ◽

The Impact ◽

Hiv 1 ◽

In Pregnancy

OBJECTIVE: To describe the impact of initiating raltegravir (RAL)-containing combination antiretroviral therapy (cART) regimens on HIV viral load (VL) in pregnant women who have high or suboptimal VL suppression late in pregnancy.METHODS: HIV-infected pregnant women who started RAL-containing cART after 28 weeks’ gestation from 2007 to 2013 were identified in two university hospital centres.RESULTS AND DISCUSSION: Eleven HIV-infected women started RAL at a median gestational age of 35.7 weeks (range 31.1 to 38.0 weeks). Indications for RAL initiation were late presentation in pregnancy (n=4) and suboptimal VL suppression secondary to poor adherence or viral resistance (n=7). Mean VL at the time of RAL initiation was 73,959 copies/mL (range <40 to 523,975 copies/mL). Patients received RAL for a median of 20 days (range one to 71 days). The mean decline in VL from the time of RAL initiation to delivery was 1.93 log, excluding one patient who received only one RAL dose and one patient with undetectable VL at the time of RAL initiation. After eight days on RAL, 50% of the women achieved a VL <1000 copies/mL (the threshold for recommended Caesarean section to reduce the risk for perinatal transmission). There were no cases of perinatal HIV transmission.CONCLUSION: The present study provides preliminary data to support the use of RAL-containing cART to expedite HIV-1 VL reduction in women who have a high VL or suboptimal VL suppression late in pregnancy, and to decrease the risk of HIV perinatal transmission while avoiding Caesarean section. Further assessment of RAL safety during pregnancy is warranted.

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