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Rapid Testing Algorithm Performance in a Low-Prevalence Environment.
- Source :
-
Sexually transmitted diseases [Sex Transm Dis] 2020 May; Vol. 47 (5S Suppl 1), pp. S35-S40. - Publication Year :
- 2020
-
Abstract
- Background: The performance of a statewide HIV rapid test algorithm (RTA) in a low-prevalence setting (0.71%) was examined for 3 years.<br />Methods: An initial rapid screening by HIV-1/2 Ag/Ab Combo test (RT#1) with Ab verification using a second, different rapid test (RT#2) was conducted. Clinic referral was immediate for antigen-only-positive screens. Antibody-positive screens were confirmed by RT#2. Specimens were collected following discordant RTA results (initially Ab-POS by RT#1, but negative on RT#2) and tested in accordance with the current Centers for Disease Control and Prevention/Association of Public Health Laboratories-based HIV diagnostic algorithm supplemented by a quantitative viral load whenever possible.<br />Results: Of 310,785 tests performed, 2400 preliminary positive screens were identified; 2191 (91.8%) confirmed by RT#2. Of 13 Determine Combo AG-POS results identified, only 1 confirmed positive. Of the remaining 196 discordant results, 182 (92.9%) were uninfected, including 13 with AG-POS/AB-POS results. Of 14 true positives (7.1%) identified after discordant RTA results, the average quantitative HIV-1 viral load was 277,385 copies/mL, but 5 (35.7%) of 14 had viral loads <1000 copies/mL. Among the 2191 "presumptive positive" by RTA, 3 false-positive (FP) RTAs were reported (both rapid tests having positive results, while the HIV-1/2 Ag/Ab assay and quantitative HIV-1 viral load showed negative results).<br />Conclusions: The RTA was effective in predicting true-positive HIV test results and facilitating linkage to care. Discordant results were infrequent. Fingerstick DC Ag detection identified a single early infection. Many discordant cases that were subsequently positive were associated with viral loads <1000 copies/mL.
- Subjects :
- Algorithms
HIV Antigens blood
HIV Infections epidemiology
HIV Infections immunology
HIV Infections virology
HIV-1 isolation & purification
HIV-2 isolation & purification
Humans
Nucleic Acid Amplification Techniques
Predictive Value of Tests
Prevalence
Sensitivity and Specificity
Antigens, Viral blood
Clinical Laboratory Techniques methods
Diagnostic Tests, Routine methods
HIV Antibodies blood
HIV Infections diagnosis
HIV-1 immunology
HIV-2 immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1537-4521
- Volume :
- 47
- Issue :
- 5S Suppl 1
- Database :
- MEDLINE
- Journal :
- Sexually transmitted diseases
- Publication Type :
- Academic Journal
- Accession number :
- 31977973
- Full Text :
- https://doi.org/10.1097/OLQ.0000000000001138