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

2018 ◽  
Vol 19 (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.

scholarly journals Evaluation of Rapid Testing Algorithms for Venue-based Anonymous HIV Testing among Non-HIV-Positive Men Who Have Sex with Men, National HIV Behavioral Surveillance (NHBS), 2017

2020 ◽  
Vol 45 (6) ◽  
pp. 1228-1235
Author(s):  
Shamaya Whitby ◽  
◽  
Amanda Smith ◽  
Rebecca Rossetti ◽  
Johanna Chapin-Bardales ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Confirmatory Test ◽  
Test Results ◽  
Rapid Testing ◽  
Behavioral Surveillance ◽  
National Hiv Behavioral Surveillance ◽  
Hiv Test ◽  
Hiv Rapid Testing ◽  
Testing Algorithms ◽  
Sex With Men

Abstract HIV rapid testing algorithms (RTAs) using any two orthogonal rapid tests (RTs) allow for on-site confirmation of infection. RTs vary in performance characteristics therefore the selection of RTs in an algorithm may affect identification of infection, particularly if acute. National HIV Behavioral Surveillance (NHBS) assessed RTAs among men who have sex with men recruited using anonymous venue-based sampling. Different algorithms were evaluated among participants who self-reported never having received a positive HIV test result prior to the interview. NHBS project areas performed sequential or parallel RTs using whole blood. Participants with at least one reactive RT were offered anonymous linkage to care and provided a dried blood spot (DBS) for testing at CDC. Discordant results (RT-1 reactive/RT-2 non-reactive) were tested at CDC with lab protocols modified for DBS. DBS were also tested for HIV-1 RNA (VL) and antiretroviral (ARV) drug levels. Of 6500 RTAs, 238 were RT-1 reactive; of those, 97.1% (231/238) had concordant results (RT-1/RT-2 reactive) and 2.9% (7/238) had discordant results. Five DBS associated with discordant results were available for confirmation at CDC. Four had non-reactive confirmatory test results that implied RT-1 false reactivity; one had ambiguous confirmatory test results which was non-reactive in further testing. Regardless of order and type of RT used, RTAs demonstrated high concordant results in the population surveyed. Additional laboratory testing on DBS following discordant results confirmed no infection. Implementing RTAs in the context of anonymous venue-based HIV testing could be an option when laboratory follow-up is not practicable.

scholarly journals Potential for false-positive HIV test results using rapid HIV testing algorithms

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Rosemary A. Audu ◽  
Rosemary N. Okoye ◽  
Chika K. Onwuamah ◽  
Fehintola A. Ige ◽  
Adesola Z. Musa ◽  
...  
Keyword(s):  
Western Blot ◽  
False Positive ◽  
Scale Up ◽  
Rapid Test ◽  
Test Results ◽  
Rapid Testing ◽  
Hiv Test ◽  
Hiv Counselling And Testing ◽  
Testing Algorithm ◽  
Hiv 1

Background: In order to scale up access to HIV counselling and testing in Nigeria, an HIV diagnostic algorithm based on rapid testing was adopted. However, there was the need to further evaluate the testing strategy in order to better assess its performance, because of the potential for false positivity.Objectives: The objective of this study was to compare positive HIV test results obtained from the approved rapid testing algorithm with results from western blot tests performed on samples from the same patient.Methodology: A retrospective review was conducted of HIV screening and confirmatory results for patients seen between 2007 and 2008. Rapid test and western blot results were extracted and compared for concordance. Discordant results were further reviewed using a combination of HIV-1 RNA viral load and CD4+ cell count test results and clinical presentation from medical records.Results: Analysis of 2228 western blot results showed that 98.3% (n = 2191) were positive for HIV-1, 0.4% (n = 8) were positive for HIV-2 and 0.3% (n = 7) were dual infections (positive for both HIV-1 and HIV-2); 0.6% (n = 13) were indeterminate and 0.4% (n = 9) were negative. Further investigation of the 13 indeterminate results showed nine to be HIV-1 positive and four to be HIV-negative, for a total of 13 negative results. The positive predictive value of the HIV counselling and testing algorithm was 99.4%.Conclusion: Using the rapid testing algorithm alone, false positives were detected. Therefore, effective measures such as training and retraining of staff should be prioritised in order to minimise false-positive diagnoses and the associated potential for long-term psychological and financial impact on the patients.

scholarly journals Potential for false positive HIV test results with the serial rapid HIV testing algorithm

2012 ◽  
Vol 5 (1) ◽  
Author(s):  
Steven Baveewo ◽  
Moses R Kamya ◽  
Harriet Mayanja-Kizza ◽  
Robin Fatch ◽  
David R Bangsberg ◽  
...  
Keyword(s):  
Hiv Testing ◽  
False Positive ◽  
Test Results ◽  
Rapid Hiv Testing ◽  
Hiv Test ◽  
Testing Algorithm

scholarly journals Routine HIV Test Results in 6 US Clinical Laboratories Using the Recommended Laboratory HIV Testing Algorithm With Geenius HIV 1/2 Supplemental Assay

2020 ◽  
Vol 47 ◽  
pp. S13-S17 ◽  
Author(s):  
Laura G. Wesolowski ◽  
Pollyanna R. Chavez ◽  
Ana María Cárdenas ◽  
Alex Katayev ◽  
Patricia Slev ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Test Results ◽  
Clinical Laboratories ◽  
Hiv Test ◽  
Testing Algorithm ◽  
Hiv 1

Genetic Exceptionalism vs. Paradigm Shift: Lessons from HIV

2001 ◽  
Vol 29 (2) ◽  
pp. 141-148 ◽  
Author(s):  
Lainie Friedman Ross
Keyword(s):  
Hiv Testing ◽  
Paradigm Shift ◽  
Test Results ◽  
Public Officials ◽  
Consent Forms ◽  
Sexually Transmitted ◽  
Anonymous Testing ◽  
Hiv Test ◽  
Immunodeficiency Virus ◽  
Hiv Exceptionalism

The term “exceptionalism” was introduced into health care in 1991 when Bayer described “HIV exceptionalism” as the policy of treating the human immunodeficiency virus (HIV) different from other infectious diseases, particularly other sexually transmitted diseases. It was reflected in the following practices: pre- and post-HIV test counseling, the development of specific separate consent forms for HIV testing, and stringent requirements for confidentiality of HIV test results. The justification for these practices was the belief that testing was essential for prevention and that patients might not seek HIV testing if confidentiality were not guaranteed. Confidentiality was believed to be particularly important given the degree of discrimination and stigmatization associated with the illness. Anonymous testing was a further step in ensuring strict confidentiality, even though such a practice prevented public officials from contacting partners and others who were at risk.

HIV Testing Behaviors Among Latina Women Tested for HIV in Florida, 2012

2017 ◽  
Vol 15 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Janelle Taveras ◽  
Mary Jo Trepka ◽  
Purnima Madhivanan ◽  
Erica L. Gollub ◽  
Jessy Devieux ◽  
...  
Keyword(s):  
United States ◽  
Hiv Testing ◽  
The United States ◽  
Test Results ◽  
Publicly Funded ◽  
Latina Women ◽  
Prevention Services ◽  
Hiv Test ◽  
Immunodeficiency Virus ◽  
Racial Ethnic

Introduction: Latina women in the United States (US) are not only disproportionately affected by human immunodeficiency virus (HIV) infection but also underuse HIV prevention services, such as HIV testing. Method: HIV testing events were examined to describe the HIV testing behaviors and test results among Latinas tested in 2012 at publicly funded sites in Florida, United States. Multivariable logistic regression was used to assess the demographic characteristics associated with reports of previous testing and positive HIV test results. Results: Of the 184,037 testing events, 87,569 (45.6%) were among non-Hispanic Blacks (NHBs), 47,926 (26.0%) non-Hispanic Whites (NHWs), 41,117 (22.3%) Latinas, 5,672 (3.1%) those with unknown race/ethnicity, and 1,753 (1.0%) other racial/ethnic groups. Compared to NHW and NHB women, Latinas testing for HIV were older (mean age = 32.1, NHW = mean age 30.3, NHB = mean age 30.0; p < .0001). Results indicated that women who reported previous HIV testing had decreased odds of being Latina (adjusted odds ratio = 0.90; 95% confidence interval [0.87, 0.94]). Conclusion: These findings indicate that Latinas are underusing HIV testing, and efforts are needed to increase the proportion of Latinas, especially younger Latinas, tested for HIV in Florida.

scholarly journals Evaluation of nine HIV rapid test kits to develop a national HIV testing algorithm in Nigeria

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Orji Bassey ◽  
Kyle Bond ◽  
Adebayo Adedeji ◽  
Odafen Oke ◽  
Ado Abubakar ◽  
...  
Keyword(s):  
Parallel Algorithms ◽  
Hiv Testing ◽  
Sensitivity And Specificity ◽  
Rapid Test ◽  
Ease Of Use ◽  
Cold Chain ◽  
Hiv Rapid Testing ◽  
Testing Algorithms ◽  
Testing Algorithm ◽  
Serial Algorithms

Background: Non-cold chain-dependent HIV rapid testing has been adopted in many resource-constrained nations as a strategy for reaching out to populations. HIV rapid test kits (RTKs) have the advantage of ease of use, low operational cost and short turnaround times. Before 2005, different RTKs had been used in Nigeria without formal evaluation. Between 2005 and 2007, a study was conducted to formally evaluate a number of RTKs and construct HIV testing algorithms. Objectives: The objectives of this study were to assess and select HIV RTKs and develop national testing algorithms. Method: Nine RTKs were evaluated using 528 well-characterised plasma samples. These comprised 198 HIV-positive specimens (37.5%) and 330 HIV-negative specimens (62.5%), collected nationally. Sensitivity and specificity were calculated with 95% confidence intervals for all nine RTKs singly and for serial and parallel combinations of six RTKs; and relative costs were estimated. Results: Six of the nine RTKs met the selection criteria, including minimum sensitivity and specificity (both ≥ 99.0%) requirements. There were no significant differences in sensitivities or specificities of RTKs in the serial and parallel algorithms, but the cost of RTKs in parallel algorithms was twice that in serial algorithms. Consequently, three serial algorithms, comprising four test kits (BundiTM, DetermineTM, Stat-Pak® and Uni-GoldTM) with 100.0% sensitivity and 99.1% – 100.0% specificity, were recommended and adopted as national interim testing algorithms in 2007. Conclusion: This evaluation provides the first evidence for reliable combinations of RTKs for HIV testing in Nigeria. However, these RTKs need further evaluation in the field (Phase II) to re-validate their performance.

scholarly journals HIV rapid testing as a key strategy for prevention of mother-to-child transmission in Brazil

2010 ◽  
Vol 44 (5) ◽  
pp. 803-811 ◽  
Author(s):  
Valdiléa G Veloso ◽  
Francisco I Bastos ◽  
Margareth Crisóstomo Portela ◽  
Beatriz Grinsztejn ◽  
Esau Custodio João ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Hiv Testing ◽  
Rio De Janeiro ◽  
Rapid Test ◽  
Rapid Testing ◽  
Child Transmission ◽  
Porto Alegre ◽  
Hiv Rapid Testing ◽  
Maternity Hospitals ◽  
Mother To Child

OBJECTIVE: To assess the feasibility of HIV rapid testing for pregnant women at maternity hospital admission and of subsequent interventions to reduce perinatal HIV transmission. METHODS: Study based on a convenience sample of women unaware of their HIV serostatus when they were admitted to delivery in public maternity hospitals in Rio de Janeiro and Porto Alegre, Brazil, between March 2000 and April 2002. Women were counseled and tested using the Determine HIV1/2 Rapid Test. HIV infection was confirmed using the Brazilian algorithm for HIV infection diagnosis. In utero transmission of HIV was determined using HIV-DNA-PCR. There were performed descriptive analyses of sociodemographic data, number of previous pregnancies and abortions, number of prenatal care visits, timing of HIV testing, HIV rapid test result, neonatal and mother-to-child transmission interventions, by city studied. RESULTS: HIV prevalence in women was 6.5% (N=1,439) in Porto Alegre and 1.3% (N=3.778) in Rio de Janeiro. In Porto Alegre most of women were tested during labor (88.7%), while in Rio de Janeiro most were tested in the postpartum (67.5%). One hundred and forty-four infants were born to 143 HIV-infected women. All newborns but one in each city received at least prophylaxis with oral zidovudine. It was possible to completely avoid newborn exposure to breast milk in 96.8% and 51.1% of the cases in Porto Alegre and Rio de Janeiro, respectively. Injectable intravenous zidovudine was administered during labor to 68.8% and 27.7% newborns in Porto Alegre and Rio de Janeiro, respectively. Among those from whom blood samples were collected within 48 hours of birth, in utero transmission of HIV was confirmed in 4 cases in Rio de Janeiro (4/47) and 6 cases in Porto Alegre (6/79). CONCLUSIONS: The strategy proved feasible in maternity hospitals in Rio de Janeiro and Porto Alegre. Efforts must be taken to maximize HIV testing during labor. There is a need of strong social support to provide this population access to health care services after hospital discharge.

scholarly journals Chronic and Early Antiretroviral Therapy Impact Human Immunodeficiency Virus (HIV) Serological Assay Sensitivity, Leading to More False-Negative Test Results in HIV Diagnosis

2020 ◽  
Vol 222 (10) ◽  
pp. 1660-1669
Author(s):  
Karolien Stoffels ◽  
Fien Vanroye ◽  
Virginie Mortier ◽  
Laurent Debaisieux ◽  
Marie-Luce Delforge ◽  
...  
Keyword(s):  
False Negative ◽  
Rapid Test ◽  
Undetectable Viral Load ◽  
Test Results ◽  
Negative Test ◽  
Immunodeficiency Virus ◽  
Confirmatory Assay ◽  
Rapid Tests ◽  
Hiv 1 ◽  
False Negative Test

Abstract This retrospective study evaluated the reactivity of 3 human immunodeficiency virus (HIV) confirmatory assays (INNO-LIA, Geenius, and MP) and 7 HIV rapid tests on samples from 2 different study populations in Belgium. For the early-treated cohort (83 HIV-1 adult patients treated within 3 months after infection), HIV-1 diagnosis was not obtained in at least 1 confirmatory assay in 12.0% (10/83) and in an HIV rapid test in 31.3% (26/83). Confirmation assay sensitivities ranged from 87.5% to 95.2%, whereas rapid test assay sensitivities ranged from 75.9% to 100%. The time to treatment initiation or the length of time on treatment did not have a statistical influence on the probability to obtain a false-negative test result. The fastest reversion was demonstrated after 4 months of treatment. Among the long-term treated cohort (390 HIV-1 patients with ≥ 9 years of undetectable viral load), false-negative test results were found in at least 1 HIV confirmatory assay for 2.1% (8/390) of the patients and in a HIV rapid test for 4.9% (19/390). Confirmation assay sensitivities ranged from 98.1% to 99.5%, whereas rapid test sensitivities ranged from 96.2% to 100%. Longer treatment increased nonreactivity of the HIV rapid tests (P = .033). Undetectable viral load decreases the sensitivities of HIV diagnostic tests, and further monitoring of the performance of serological assays is advised.

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

2009 ◽  
Vol 51 (5) ◽  
pp. 273-276 ◽  
Author(s):  
Luiz Euribel Prestes-Carneiro ◽  
Nadia Araújo Miguel ◽  
Eloah Lopes Ascêncio ◽  
Marisa Amâncio ◽  
Vera Lúcia Maria Alcântara ◽  
...  
Keyword(s):  
Viral Load ◽  
Pregnant Women ◽  
Teaching Hospital ◽  
Rapid Test ◽  
Perinatal Transmission ◽  
Immunofluorescence Assay ◽  
Rapid Testing ◽  
Gynecology And Obstetrics ◽  
Hiv Test ◽  
Rapid Hiv Test

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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