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Determination of HIV status in African adults with discordant HIV rapid tests

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dc.date.accessioned 2020-02-19T16:35:22Z
dc.date.available 2020-02-19T16:35:22Z
dc.date.issued 2016-01-25 en
dc.identifier.uri http://hdl.handle.net/20.500.11910/1674
dc.description.abstract In resource-limited settings, HIV infection is often diagnosed using 2 rapid tests. If the results are discordant, a third tiebreaker test is often used to determine HIV status. This study characterized samples with discordant rapid tests and compared different testing strategies for determining HIV status in these cases. Samples were previously collected from 173 African adults in a population-based survey who had discordant rapid test results. Samples were classified as HIV positive or HIV negative using a rigorous testing algorithm that included two fourth generation tests, a discriminatory test, and 2 HIV RNA tests. Tie-breaker tests were evaluated, including rapid tests (1 performed in-country), a third-generation enzyme immunoassay, and two fourth-generation tests. Selected samples were further characterized using additional assays. Twenty-nine samples (16.8%) were classified as HIV positive and 24 of those samples (82.8%) had undetectable HIV RNA. Antiretroviral drugs were detected in 1 sample. Sensitivity was 8.3%-43% for the rapid tests; 24.1% for the third-generation enzyme immunoassay; 95.8% and 96.6% for the fourth-generation tests. Specificity was lower for the fourth-generation tests than the other tests. Accuracy ranged from 79.5% to 91.3%. In this population-based survey, most HIV-infected adults with discordant rapid tests were virally suppressed without antiretroviral drugs. Use of individual assays as tie-breaker tests was not a reliable method for determining HIV status in these individuals. More extensive testing algorithms that use a fourth-generation screening test with a discriminatory test and HIV RNA test are preferable for determining HIV status in these cases. en
dc.format.medium Print en
dc.publisher Lippincott, Williams & Wilkins en
dc.subject HIV/AIDS en
dc.subject ADULTS en
dc.subject HIV TESTING AND COUNSELLING (HTC) en
dc.subject HIV/AIDS STATUS en
dc.title Determination of HIV status in African adults with discordant HIV rapid tests en
dc.type Journal Article en
dc.description.version Y en
dc.ProjectNumber N/A en
dc.Volume 69(4) en
dc.BudgetYear 2015/16 en
dc.ResearchGroup HIV/AIDS, STIs and TB en
dc.SourceTitle JAIDS - Journal of Acquired Immune Deficiency Syndromes en
dc.PlaceOfPublication Philadelphia, USA en
dc.ArchiveNumber 8951 en
dc.PageNumber 430-438 en
dc.outputnumber 7743 en
dc.bibliographictitle Fogel, J.M., Piwowar-Manning, E., Donohue, K., Cummings, V., Marzinke, M.A., Clarke, W., Breaud, A., Fiamma, A., Donnell, D., Kulich, M., Mbwambo, J.K.K., Richter, L., Gray, G., Sweat, M., Coates, T.J. & Eshleman, S.H. (2015) Determination of HIV status in African adults with discordant HIV rapid tests. <i>JAIDS - Journal of Acquired Immune Deficiency Syndromes</i>. 69(4):430-438. en
dc.publicationyear 2015 en
dc.contributor.author1 Fogel, J.M. en
dc.contributor.author2 Piwowar-Manning, E. en
dc.contributor.author3 Donohue, K. en
dc.contributor.author4 Cummings, V. en
dc.contributor.author5 Marzinke, M.A. en
dc.contributor.author6 Clarke, W. en
dc.contributor.author7 Breaud, A. en
dc.contributor.author8 Fiamma, A. en
dc.contributor.author9 Donnell, D. en
dc.contributor.author10 Kulich, M. en
dc.contributor.author11 Mbwambo, J.K.K. en
dc.contributor.author12 Richter, L. en
dc.contributor.author13 Gray, G. en
dc.contributor.author14 Sweat, M. en
dc.contributor.author15 Coates, T.J. en
dc.contributor.author16 Eshleman, S.H. en


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