Programmatic Evaluation of a Combined Antigen and Antibody Test for Rapid HIV Diagnosis in a Community and Sexual Health Clinic Screening Programme

Taegtmeyer, Miriam; MacPherson, Peter; Jones, Kathy; Hopkins, Mark; Moorcroft, Jay; Lalloo, David G.; Chawla, Anu
November 2011
PLoS ONE;2011, Vol. 6 Issue 11, p1
Academic Journal
Background: A substantial proportion of HIV-infected individuals in the UK are unaware of their status and late presentations continue, especially in low prevalence areas. Fourth generation antigen/antibody rapid test kits could facilitate earlier diagnosis of HIV in non-clinical settings but lack data on performance under programmatic conditions. Methods and Findings: We evaluated the performance of Determine HIV-1/2 Ag/Ab Combo Test (Determine Combo), a rapid test with indicators for both HIV antibodies and p24 antigen, in participants recruited from community outreach and hospital-based sexual health clinics. HIV infection was confirmed using laboratory enzyme-linked immunosorbent assay (EIA), Line Immuno Assay (LIA) and quantitative polymerase chain reaction (PCR). In total, 953 people underwent HIV testing. HIV antibody (Ab) prevalence was 1.8% (17/953). Four false positive rapid tests were identified: two antibody and two p24 antigen (Ag) reactions. Of participants diagnosed as HIV Ab positive, 2/17 (12%) were recent seroconverters based on clinical history and HIV antibody avidity test results. However, none of these were detected by the p24 antigen component of the rapid test kit. There were no other true positive p24 Ag tests. Conclusion: These data lend support to an increasing body of evidence suggesting that 4th generation rapid HIV tests have little additional benefit over 3rd generation HIV kits for routine screening in low prevalence settings and have high rates of false positives. In order to optimally combine community-based case-finding among hard-to-reach groups with reliable and early diagnosis 3rd generation kits should be primarily used with laboratory testing of individuals thought to be at risk of acute HIV infection. A more reliable point of care diagnostic is required for the accurate detection of acute HIV infection under programmatic conditions.


Related Articles

  • Early Infant Diagnosis: A New Tool of HIV Diagnosis in Children. Jain, Kamlesh Kumar; Mahajan, Raj Kumar; Shevkani, Manoj; Kumar, Pradeep // Indian Journal of Community Medicine;Apr2011, Vol. 36 Issue 2, p139 

    Background: Standard assay has limited utility in diagnosing HIV reactivity among infants till the age of 18 months by which time, many HIV-infected infants expire. The test for diagnosing infant and children below 18 months is DNA polymerase chain reaction (DNAPCR) either by dried blood spot...

  • Quantification of human immunodeficiency virus using quantitative polymerase chain reaction (PCR) compared to ELISA in early diagnosis of infection. Aghamirzaei, Seyedeh Tahereh; Hemati, Amin; Arjunan, Selvam // Advances in Applied Science Research;2014, Vol. 5 Issue 3, p64 

    In the era of modern medicine, owing to an increasing incidence of HIV infection, many indirect tests including ELISA are readily available for the detection of HIV infection. However, they are not useful in early diagnosis of HIV infection. As early diagnosis is vital to treat HIV infection...

  • Detection of Acute HIV Infection: A Field Evaluation of the Determine® HIV-1/2 Ag/Ab Combo Test. Rosenberg, Nora E.; Kamanga, Gift; Phiri, Sam; Nsona, Dominic; Pettifor, Audrey; Rutstein, Sarah E.; Kamwendo, Deborah; Hoffman, Irving F.; Keating, Maria; Brown, Lillian B.; Ndalama, Beatrice; Fiscus, Susan A.; Congdon, Seth; Cohen, Myron S.; Miller, William C. // Journal of Infectious Diseases;2/15/2012, Vol. 205 Issue 4, p528 

    Background. Most human immunodeficiency virus (HIV) point-of-care tests detect antibodies (Ab) but not p24 antigen (Ag) or RNA. In the absence of antibodies, p24 antigen and RNA typically indicate acute HIV infection. We conducted a field evaluation of the Determine® HIV-1/2 Ag/Ab Combo rapid...


    No abstract available.

  • Laboratory diagnosis of HIV infection: An update. Bastian, T. S.; Denny, Ceena E.; Shrivastava, Shikha; Saxena, Manish // Indian Journal of Public Health Research & Development;Jan-Jun2010, Vol. 1 Issue 1, p11 

    The number of HIV infected cases is increasing worldwide at an alarming rate. Although public education has been initiated for awareness and behavioural modification for this devastating infection, better diagnostic methods are needed to identify infected persons and manage infection. Simple and...

  • Mannose-binding protein in HIV-seropositive patients does not contribute to disease progression or bacterial infections. McBride, M. O.; Fischer, P. B.; Sumiya, M.; McClure, M. O.; Turner, M. W.; Skinner, C. J.; Weber, J. N.; Summerfield, J. A. // International Journal of STD & AIDS;Nov1998, Vol. 9 Issue 11, p683 

    This study set out to investigate whether plasma mannose-binding protein (MBP) deficiency caused by mutations in the MBP gene associates with pyogenic or opportunistic infections in HIV-infected patients. Plasma samples were selected randomly from 131 HIV-infected patients followed prospectively...

  • In Vitro Anti-HIV-1 Activity of the Aqueous Extract of Asterina Pectinifera. Karadeniz, Fatih; Karagozlu, Mustafa Zafer; Chang-Suk Kong; Se-Kwon Kim // Current HIV Research;Mar2011, Vol. 9 Issue 2, p95 

    No abstract available.

  • Rotavirus Infections among HIV-Infected Children in Nairobi, Kenya. Kiulia, Nicholas M.; Nyaundi, Julia K.; Peenze, Ina; Nyachieo, Atunga; Musoke, Rachel N.; Steele, Andrew D.; Mwenda, Jason M. // Journal of Tropical Pediatrics;Oct2009, Vol. 55 Issue 5, p318 

    Human rotaviruses have emerged as a leading cause of acute diarrhea in children <5 years of age worldwide. Although there are previous reports relating to various aspects of rotaviruses, there is limited data on the involvement of rotavirus infection in HIV-infected children. We therefore...

  • Reduction of Antimalarial Antibodies by HIV Infection Is Associated With Increased Risk of Plasmodium falciparum Cord Blood Infection. Naniche, Denise; Serra-Casas, Elisa; Bardají, Azucena; Quintó, Llorenç; Dobaño, Carlota; Sigauque, Betuel; Cisteró, Pau; Chauhan, Virander S.; Chitnis, Chetan E.; Alonso, Pedro L.; Menéndez, Clara; Mayor, Alfredo // Journal of Infectious Diseases;2/15/2012, Vol. 205 Issue 4, p568 

    Background. Plasmodium falciparum infection in pregnancy can lead to congenital malaria, which has detrimental health consequences for infants. Human immunodeficiency virus (HIV) might increase cord blood P. falciparum infection by decreasing maternal antimalarial-specific antibodies. Methods....


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics