Evaluation of Rapid Prenatal Human Immunodeficiency Virus Testing in Rural Cameroon

Abstract

Pregnant women (n ‫؍‬ 859) in rural Cameroonian prenatal clinics were screened by two rapid human immunodeficiency virus (HIV) antibody tests (rapid tests [RT]) (Determine and Hema-Strip) using either whole blood or plasma. One additional RT (Capillus, HIV-CHEK, or Sero-Card) was used to resolve discordant results. RT results were compared with HIV-1 enzyme immunoassay (EIA) and Western blot (WB) results of matched dried blood spots (DBS) to assess the accuracy of HIV RTs. DBS EIA/WB identified 83 HIV antibody-reactive, 763 HIV antibody-nonreactive, and 13 indeterminate specimens. RT results were evaluated in serial (two consecutive tests) or parallel (two simultaneous tests) testing algorithms. A serial algorithm using Determine and Hema-Strip yielded sensitivity and specificity results of 97.6% and 99.7%, respectively, whereas a parallel RT algorithm using Determine plus a second RT produced a sensitivity and specificity of 100% and 99.7%, respectively. HIV RTs provide excellent alternatives for identifying HIV infection, and their field performance could be monitored using DBS testing strategies.

Frequency, Causes, and New Challenges of Indeterminate Results in Western Blot Confirmatory Testing for Antibodies to Human Immunodeficiency Virus

“…The screen algorithm comprising repeat testing with one ELISA instead of the ELISA in combination with a more specific agglutination test generated not only more FPs (143 versus 8), but also more WBi results (88 [36.5%] versus 2 [10%]) with the same testing cohort of 281 samples (36). Separately, it is also noteworthy that 13 WBi results were fully resolved when an additional screen assay was introduced into the testing algorithm prior to the Western blot confirmation (33).…”

“…While these approaches might have proven cost-effective in some resource-lacking countries, with different cohorts, or even with different types of specimens (24,33,56,82), the impacts of the recommendations on diagnostic and detection outcomes are beyond immediate comprehension. In pursuing the recommended strategies, various combinations of test kits were reviewed and ultimately adopted in routine HIV testing.…”

Rapid Detection and Differentiation of Antibodies to HIV-1 and HIV-2 Using Multivalent Antigens and Magnetic Immunochromatography Testing

“…These assays are primarily designed as lateral-flow formats that use colored detection reagents, such as colloidal gold or selenium, conjugated to HIV antigens or to proteins that bind to specific human immunoglobulins, such as protein A or G (10). The tests are rapid, inexpensive, and stable over a broad temperature range and are simple to perform, requiring no additional equipment (1).…”

Suitability of Simple Human Immunodeficiency Virus Rapid Tests in Clinical Trials in Community-Based Clinic Settings

“…Reported sensitivities and specificities of the Capillus SR test are 99 to 100% (3,16). We found the specificities of Determine and Capillus to be within the reported range.…”

“…The Determine SR test has been reported to have sensitivities and specificities of 100% and 99 to 100%, respectively (3,16). Reported sensitivities and specificities of the Capillus SR test are 99 to 100% (3,16).…”