scholarly journals Absence of routine molecular testing and prevalence of HIV-2 infection in regions hardest-hit by HIV infection

2012 ◽  
Vol 6 (12) ◽  
pp. 854-859 ◽  
Author(s):  
Joseph C Forbi ◽  
Mathew D Esona ◽  
Hellen O Iperepolu ◽  
Moses P Adoga ◽  
Simon M Agwale
Keyword(s):  
Hiv Infection ◽  
Sex Workers ◽  
False Negative ◽  
Rapid Test ◽  
Molecular Testing ◽  
Test Results ◽  
Active Population ◽  
Hiv Test ◽  
In Series ◽  
Hiv 1

Introduction: Investigating the incidence and dynamics of HIV-2 and false-negative HIV test results in a highly sexually active population where frequent opportunities exist for acquiring and transmitting infections provides additional understanding of the epidemiology of the virus in Africa. Methodology: The HIV status of 900 active female sex workers (FSWs) was determined using two lateral flow rapid assays in series. The second rapid test device incorporates type-specific recombinant peptides that discriminate between HIV-1 and HIV-2 infection. HIV sero-negative samples were re-tested for HIV infection and their viral loads determined using the NucliSENS real-time nucleic acid sequence-based amplification (NASBA) platform. Results: In total, 335 FSWs were determined to be HIV positive, the majority (227; 67.8%) of whom were between the ages of 20 and 30 years. Eighteen (5.4%) were found to have evidence of HIV-2 infection, 17 of whom were co-infected with HIV-1. Only one HIV-2 mono-infection was observed. Out of 565 HIV-negative individuals determined by serology, 11(1.9%; p>0.05) were found to be HIV-1 positive when tested via the NASBA platform. Conclusion: False negative test results, HIV-2 infection, and complex transmission networks among FSWs may aid in fueling the HIV epidemic in the Nigerian population. These findings demonstrate the need to reevaluate the quality of HIV serological diagnostics, control services, and stress the need for widespread introduction of molecular testing among high-risk populations in the country.

scholarly journals Prospective Evaluation of HIV Testing Technologies in a Clinical Setting: Protocol for Project DETECT (Preprint)

2019 ◽  
Author(s):  
Joanne D Stekler ◽  
Lauren R Violette ◽  
Hollie A Clark ◽  
Sarah J McDougal ◽  
Lisa A Niemann ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Prospective Study ◽  
Hiv Testing ◽  
Transmitted Disease ◽  
The United States ◽  
Test Results ◽  
Cross Sectional ◽  
Hiv Test ◽  
Hiv Acquisition ◽  
Hiv 1

BACKGROUND HIV testing guidelines provided by the Centers for Disease Control and Prevention (CDC) are continually changing to reflect advancements in new testing technology. Evaluation of existing and new point-of-care (POC) HIV tests is crucial to inform testing guidelines and provide information to clinicians and other HIV test providers. Characterizing the performance of POC HIV tests using unprocessed specimens can provide estimates for the window period of detection, or the time from HIV acquisition to test positivity, which allows clinicians and other HIV providers to select the appropriate POC HIV tests for persons who may be recently infected with HIV. OBJECTIVE This paper describes the protocols and procedures used to evaluate the performance of the newest POC tests and determine their sensitivity during early HIV infection. METHODS Project DETECT is a CDC-funded study that is evaluating POC HIV test performance. Part 1 is a cross-sectional, retrospective study comparing behavioral characteristics and HIV prevalence of the overall population of the Public Health–Seattle & King County (PHSKC) Sexually Transmitted Disease (STD) Clinic to Project DETECT participants enrolled in part 2. Part 2 is a cross-sectional, prospective study evaluating POC HIV tests in real time using unprocessed whole blood and oral fluid specimens. A POC nucleic acid test (NAT) was added to the panel of HIV tests in June 2018. Part 3 is a longitudinal, prospective study evaluating seroconversion sensitivity of POC HIV tests through serial follow-up testing. For comparison, HIV-1 RNA and HIV-1/HIV-2 antigen/antibody tests are also performed for participants enrolled in part 2 or 3. A behavioral survey that collects information about demographics, history of HIV testing, STD history, symptoms of acute HIV infection, substance use, sexual behaviors in the aggregate and with recent partners, and use of pre-exposure prophylaxis and antiretroviral therapy is completed at each part 2 or 3 visit. RESULTS Between September 2015 and March 2019, there were 14,990 Project DETECT–eligible visits (part 1) to the PHSKC STD Clinic resulting in 1819 part 2 Project DETECT study visits. The longitudinal study within Project DETECT (part 3) enrolled 27 participants with discordant POC test results from their part 2 visit, and 10 (37%) were followed until they had fully seroconverted with concordant positive POC test results. Behavioral survey data and HIV test results, sensitivity, and specificity will be presented elsewhere. CONCLUSIONS Studies such as Project DETECT are critical for evaluating POC HIV test devices as well as describing characteristics of persons at risk for HIV acquisition in the United States. HIV tests in development, including POC NATs, will provide new opportunities for HIV testing programs. INTERNATIONAL REGISTERED REPORT RR1-10.2196/16332

scholarly journals Prospective Evaluation of HIV Testing Technologies in a Clinical Setting: Protocol for Project DETECT

10.2196/16332 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e16332 ◽  
Author(s):  
Joanne D Stekler ◽  
Lauren R Violette ◽  
Hollie A Clark ◽  
Sarah J McDougal ◽  
Lisa A Niemann ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Prospective Study ◽  
Hiv Testing ◽  
Transmitted Disease ◽  
The United States ◽  
Test Results ◽  
Cross Sectional ◽  
Hiv Test ◽  
Hiv Acquisition ◽  
Hiv 1

Background HIV testing guidelines provided by the Centers for Disease Control and Prevention (CDC) are continually changing to reflect advancements in new testing technology. Evaluation of existing and new point-of-care (POC) HIV tests is crucial to inform testing guidelines and provide information to clinicians and other HIV test providers. Characterizing the performance of POC HIV tests using unprocessed specimens can provide estimates for the window period of detection, or the time from HIV acquisition to test positivity, which allows clinicians and other HIV providers to select the appropriate POC HIV tests for persons who may be recently infected with HIV. Objective This paper describes the protocols and procedures used to evaluate the performance of the newest POC tests and determine their sensitivity during early HIV infection. Methods Project DETECT is a CDC-funded study that is evaluating POC HIV test performance. Part 1 is a cross-sectional, retrospective study comparing behavioral characteristics and HIV prevalence of the overall population of the Public Health–Seattle & King County (PHSKC) Sexually Transmitted Disease (STD) Clinic to Project DETECT participants enrolled in part 2. Part 2 is a cross-sectional, prospective study evaluating POC HIV tests in real time using unprocessed whole blood and oral fluid specimens. A POC nucleic acid test (NAT) was added to the panel of HIV tests in June 2018. Part 3 is a longitudinal, prospective study evaluating seroconversion sensitivity of POC HIV tests through serial follow-up testing. For comparison, HIV-1 RNA and HIV-1/HIV-2 antigen/antibody tests are also performed for participants enrolled in part 2 or 3. A behavioral survey that collects information about demographics, history of HIV testing, STD history, symptoms of acute HIV infection, substance use, sexual behaviors in the aggregate and with recent partners, and use of pre-exposure prophylaxis and antiretroviral therapy is completed at each part 2 or 3 visit. Results Between September 2015 and March 2019, there were 14,990 Project DETECT–eligible visits (part 1) to the PHSKC STD Clinic resulting in 1819 part 2 Project DETECT study visits. The longitudinal study within Project DETECT (part 3) enrolled 27 participants with discordant POC test results from their part 2 visit, and 10 (37%) were followed until they had fully seroconverted with concordant positive POC test results. Behavioral survey data and HIV test results, sensitivity, and specificity will be presented elsewhere. Conclusions Studies such as Project DETECT are critical for evaluating POC HIV test devices as well as describing characteristics of persons at risk for HIV acquisition in the United States. HIV tests in development, including POC NATs, will provide new opportunities for HIV testing programs. International Registered Report Identifier (IRRID) RR1-10.2196/16332

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 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 Do I Have HIV or Not? Lack of RNA Detection and the Case for Sensitive DNA Testing

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Sandra A Springer ◽  
Silvina Masciotra ◽  
Jeffrey A Johnson ◽  
Sheldon Campbell
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Viral Rna ◽  
Infection Status ◽  
Test Results ◽  
Dna Testing ◽  
Rna Detection ◽  
Hiv Test

Abstract We present a case of a 20-year-old male who had ambiguous HIV test results after entering new provider care and whose status was later complicated by undetectable viral RNA off antiretroviral therapy (ART). Verifying HIV infection status may occasionally require sensitive DNA testing that might need to be considered in diagnostic guidelines to resolve diagnosis and ensure appropriate ART management.

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

INCIDENCE OF HIV-1 AND HIV-2 ANTIBODIES IN HEMOPHILIACS

1987 ◽  
Author(s):  
W Schramm ◽  
L G Gürtler ◽  
H Pohlmann ◽  
I Weigel ◽  
J Eberie ◽  
...  
Keyword(s):  
The Other ◽  
Clotting Factor ◽  
Test Results ◽  
Clotting Factors ◽  
Negative Results ◽  
Group 12 ◽  
Hiv Test ◽  
In The Beginning ◽  
Anti Hiv ◽  
Hiv 1

The presence of antibodies to HIV-1 (anti-HIV-1) was tested in 167 hemophiliacs surveyed and treated at Munich hemophilia center. Increasing numbers of HIV infected patients were observed in the years 1981 to 1986 from 0% to 51,5% (86 positive patients in January 1987 of 167 followed patients). Most of the seroconver-sions occured between 1982 and 1984. The 150 clinically severe affected hemophiliacs (F-VIII-levels up to 5% and need of replacement therapy) showed positive HIV-test results in 55,3% (83 patients) and negative results in 44,7% (67 patients). 5 patients died since 1981, one because of AIDS. 17 patients were not seen since 1984, 14 of those belong to the severly affected group, 12 of them were negative. Since spring 1985 only heat or chemically treated clotting factor preparations are used for substitution. Despite this still 5 seroconversions were observed. Two may be attributed to the use of a preparation heat inactivated in dry state, this preparation is no longer used. The other 3 seroconversions possibly were caused by an occasional use of an noninactivated preparation in the beginning of the change to inactivated clotting factor preparations. 38 of the anti-HIV-1 positive sera were tested for the presence of HIV-2 antibodies also. The methods were ELISA,immunofluorescence and immunoblot. HIV-2 (LAV-2) for these tests was kindly provided by L. Montagnier. Antibodies specific for HIV-2 antigens were not detected, but crossreactions were observed between anti-HIV-1 with HIV-2 antigens particularly epitopes on HIV-2-p27.The data indicate that the use of adequately inactivated clotting factors can prevent infection of hemophilia patients by this route and that HIV-2 was not present in the clotting factor preparations used for the substitution of this group of patients. The incidence of full blown AIDS since 1981 in our group of hemophiliacs is still low (1,2%).

scholarly journals Characterization of New HIV Infections among Adults ≥45 Years—New York City, North Carolina, San Francisco, 2011–2013

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S15-S15
Author(s):  
Mary Evans ◽  
Anne Patala ◽  
Ellsworth Campbell ◽  
Emily Westheimer ◽  
Cynthia L Gay ◽  
...  
Keyword(s):  
Older Adults ◽  
Hiv Prevention ◽  
Hiv Infection ◽  
San Francisco ◽  
Acute Infection ◽  
Study Participant ◽  
Rapid Test ◽  
Bivariate Analysis ◽  
Similar Frequency ◽  
Hiv 1

Abstract Background While HIV prevention activities are often focused on younger people, older people can also be at risk for HIV infection. We aimed to characterize HIV transmission in older adults. Methods The STOP study was a multi-site prospective study of persons with acute HIV infection (AHI) from 2011 to 2013. Older adults were defined as ≥45 years and younger persons were 13–44 years. AHI was defined by a negative rapid test but a reactive antigen/antibody or HIV RNA test. We performed bivariate analysis using Pearson’s chi-square and odds ratios to examine associations between older age and transmission characteristics. Among persons with HIV-1 polymerase (pol) sequences, transmission linkages were inferred when the genetic distance between sequences was <1.5% and did not indicate directionality of transmission. Results Among 86,836 participants (median age, 29 years; 75.0% male; 51.8% MSM), HIV infection was diagnosed in 176 (1.46%) of 12,036 older adults compared with 1,150 (1.53%) of 74,800 younger people (P = 0.56). Among HIV-infected persons, AHI was diagnosed in similar proportions of older and younger people (13.1% vs. 12.6%; P = 0.86). Among HIV-infected persons who participated in partner notification (n = 1,326), older adults were less likely to report meeting a sex partner online (11.3% vs. 26.9%; OR 0.52, 95% CI = 0.35–0.78) and were less likely to name ≥2 sex partners (31.5% vs. 46.8%; OR = 0.28, 95% CI = 0.15–0.53) compared with younger people. Among HIV-infected persons with HIV-1 pol sequences (n = 537), similar proportions of older and younger people had viruses that genetically linked with another study participant (15.9% vs. 23.5%; OR 0.62, 95% CI 0.31–1.22) (Figure). Conclusion In this study, older adults had a similar frequency of newly diagnosed HIV infection, acute infection, and genetic linkage compared with younger people, suggesting that increased HIV prevention efforts may be needed in this population. Disclosures All authors: No reported disclosures.

scholarly journals HIV Seroprevalence among the Patients or Clients Obtaining Blood Sample at BSMMU Virology Laboratory

2021 ◽  
Vol 2 (1) ◽  
pp. 15-19
Author(s):  
Nahida Sultana ◽  
Mahbuba Sharmin ◽  
Tangia Muquith ◽  
Umme Shahera
Keyword(s):  
Hiv Infection ◽  
Sex Workers ◽  
Drug Users ◽  
Adult Population ◽  
Critical Role ◽  
Age Group ◽  
Hiv Test ◽  
History Of ◽  
Exposure History ◽  
Anti Hiv

Departments of Virology (DVs), BSMMU receive patients from every background, socioeconomic group and health status. Hence, DVs can play a critical role in offering human immunodeficiency virus (HIV) testing and help in the national strategy of early HIV detection. The present study was conducted on 1208 patients attending DVs after taking Institutional Review Board approval. They were screened for HIV antibodies by three rapid/simple assay tests having different principles/antigens as per the WHO guidelines. Forty four (13.6%) of the 1208 patients were HIV reactive and 1164(96.4%) were negative respectively. Distribution of patients on the basis of gender where 894 (74.1%) were male and 313 (25.9%) were female out of 1208 patients or clients. Distribution of study subject on the basis of exposure history where 378(38.8%) patients or clients had history of exposure and 830 (68.7%) patients or clients did not. Distribution of the patients on the basis of purpose of screening where patients were in three groups (Screening before operation, Positive exposure history and To exclude HIV infection during failure of drug Rx) where 776(64.2%) patients were done anti-HIV test due to screening purpose before operation, 378(31.1%) patients were done this test due to Positive exposure history exposure history and 54(4.5%) patients done this due to exclude HIV infection during failure of drug treatment. Prevalence of HIV infection was more among 21-40yrs age group than other age group(18mon-20yrs,41-60yrs&>60yrs) which is not significant . Data shows there was significant association of anti-HIV positivity with exposure history of the patients or clients. Prevalence of HIV infection was more among patients or clients who had history of exposure. Prevalence of HIV was more among the patients who were done screening test due to failure of drugs than other two purposes. Bangladesh is still considered as a low HIV/AIDS prevalent country. However, it is at a critical moment in the course of its AIDS epidemic. It is estimated that there are 13,000 HIV-positive people in the country and that HIV prevalence in the adult population is less than 0.01%. However, the country's vulnerability is very high. National HIV surveillance indicates that the rate of HIV infection among street-based sex workers in central Bangladesh is high compared with sex workers in other parts of South Asia. HIV among injecting drug users is already 10.5%.The presence of covert multi-partner sexual activity and denial, the low level of knowledge and low condom use, unsafe professional blood donations, lack of a desirable environment and violation of Human Rights, all contribute to the spread of HIV in Bangladesh. Thus, the study emphasizes the need for expansion of routine voluntary HIV counseling and testing to all the patients who come to the DV and practicing universal work precautions by health care workers.  

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