Field evaluation of alternative testing strategies for diagnosis and differentiation of HIV-1 and HIV-2 infections in an HIV-1 and HIV-2-prevalent area

Andersson, Sören; Z, da Silva; Norrgren, Hans; Dias, F; Biberfeld, Gunnel

doi:10.1097/00002030-199715000-00005

Cited by 79 publications

(57 citation statements)

References 22 publications

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“…Our survey, carried out as part of the ANRS 1201/1202 Ditrame Plus program for PMTCT (Abidjan, Côte d'Ivoire), demonstrated the ability of a serial algorithm to function accurately under actual West African field conditions in the context of the circulation of the predominant subtype, HIV-1 CRF02. Our data confirm and extend the findings of others (1,2,17,18,29). Despite difficult working conditions in the peripheral laboratories (no air conditioning, frequent power failures, and little equipment), our strategy achieved maximum initial sensitivity with the first-line rapid assay (in our experience, no HIV infection in an HIV-infected woman was missed by using the Determine test) and a high specificity with the second one (the Genie II assay).…”

Section: Discussionsupporting

confidence: 88%

“…However, the field performance of these alternative rapid assays is still poorly documented (20,24,25,29,31). Most of the published evaluations, including those performed in Africa (1,2,13,18,30), were done retrospectively in reference laboratories with stored plasma and/or with limited numbers of samples taken prospectively. Additionally, it must be pointed out that these evaluations must take into account two supplementary challenges in Africa.…”

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confidence: 99%

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Field Evaluation of a Rapid Human Immunodeficiency Virus (HIV) Serial Serologic Testing Algorithm for Diagnosis and Differentiation of HIV Type 1 (HIV-1), HIV-2, and Dual HIV-1-HIV-2 Infections in West African Pregnant Women

et al. 2004

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We evaluated a two-rapid-test serial algorithm using the Determine and Genie II rapid assays, performed on-site in four peripheral laboratories during the French Agence Nationale de Recherches sur le SIDA ( , respectively. The specificities were 98.4% (95% CI, 96.9 to 99.3%) and 100% (95% LL, 99.3%), respectively. All serological assays gave concordant results for infections with single types. By contrast, for samples found to be infected with dual HIV types by the Genie II assay, dual reactivity was detected for only 37 samples (52.1%) by WB assays, 34 samples (47.9%) by the Peptilav assay, and 23 samples (32.4%) by the monospecific ELISAs. For specimens with dual reactivity by the Genie II assay, the rates of concordance between the real-time PCR assays and the serological assays were 25.7% for the Genie II assay, 82.9% for the Peptilav assay, 74.3% for WB assays, and 80% for the homemade ELISAs. Our algorithm provided high degrees of sensitivity and specificity comparable to those of ELISAs. Even if they are rare, women identified by the Genie II assay as being infected with HIV-1 and HIV-2 mostly appeared to be infected only with HIV-2.Human immunodeficiency virus (HIV) antibody testing is a critical step that allows the implementation of effective prevention and care interventions in HIV-infected individuals. Simple voluntary counseling and testing (VCT) approaches are increasingly required, especially in situations in which the rapid identification of HIV infection is warranted, such as in pregnant women during gestation and in the peripartum period (3, 6, 13). For instance, among pregnant women attending antenatal clinics in Côte d'Ivoire, among whom the prevalence of HIV infection is estimated to be 10%, the increasing implementation of low-cost interventions to reduce mother-to-child transmission (MTCT) with short antiretroviral regimens has created new demands for VCT (22).For this purpose, the use of standard enzyme-linked immunosorbent assays (ELISAs), designed for batch testing, followed by confirmatory Western blot (WB) tests, if necessary, is now considered time-and money-consuming (5, 23). Sophisticated equipment (such as automatic pipettes, incubators, washers, and readers) must be available, is costly to purchase and maintain, and must be located near clean water and a reliable supply of electricity. The validity of the results obtained by these techniques strongly depends on the skills of the technicians, and their interpretation requires skills training and supervision. These conditions are often lacking in sub-Saharan Africa, at least in district-level hospitals. Finally, given the important delay between HIV antibody testing by standard procedures and the availability of results, a significant number of people do not return for posttest counseling (21).

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Section: Discussionsupporting

confidence: 88%

mentioning

confidence: 99%

Field Evaluation of a Rapid Human Immunodeficiency Virus (HIV) Serial Serologic Testing Algorithm for Diagnosis and Differentiation of HIV Type 1 (HIV-1), HIV-2, and Dual HIV-1-HIV-2 Infections in West African Pregnant Women

et al. 2004

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“…Testing strategies for HIV must include an algorithm for the second-round testing of all reactive or inconclusive samples from the initial screening assay to determine whether the initial reactivities were true or false (1,24,31). Samples interpreted as inconclusive or reactive should be retested in a second assay that uses a different technology and antigens.…”

Section: Discussionmentioning

confidence: 99%

Assessing Proficiency of Interpretation of Rapid Human Immunodeficiency Virus Assays in Nonlaboratory Settings: Ensuring Quality of Testing

et al. 2008

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Rapid antibody tests for the detection of human immunodeficiency virus (HIV) offer an effective means of providing a timely result of HIV serostatus to individuals. The increased use of rapid HIV antibody tests outside the laboratory has highlighted the need for new, cost-effective quality assurance methods to be developed for use in nonlaboratory-based and resource-limited settings. Photographed rapid HIV test results were used in a modified external quality assessment scheme to assess the interpretation proficiency and, therefore, to assess the feasibility of using this method as a basis for a quality assessment program for nonlaboratory-based testing. Participants (n ‫؍‬ 148), both experienced and inexperienced in the performance and interpretation of rapid HIV testing, interpreted the photographed results of five rapid HIV assays. These were scored according to the degree of technical discordance. Error scores were grouped according to each participant's technical experience. The accuracy of interpretation for four of the five assays was between 80 and 97%, indicating that the photographed results of samples, including those difficult to read or borderline difficult to read, can be used to assess the proficiency of test operators in interpreting results. Participants had greater difficulty in interpreting samples of weak reactivity; this was consistent across the five assays. Experience played an important role in accurate interpretation, with experienced laboratory participants exhibiting greater proficiency (P < 0.05) in interpreting the results of three of the five rapid HIV assays. It was established that photographed results of rapid HIV assays could be interpreted with accuracy and demonstrated that prior experience resulted in a more accurate interpretation performance.

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“…Screening-reactive samples were confirmed by Pepti-LAV 1-2 (Sanofi Diagnostics Pasteur, Marnes-la-Coquette, France) as previously described (20). The group of healthy controls was tested for HIV antibodies in accordance with a similar alternative testing strategy described elsewhere (3).…”

Section: Study Groupsmentioning

confidence: 99%

Potent Neutralizing Serum Immunoglobulin A (IgA) in Human Immunodeficiency Virus Type 2-Exposed IgG-Seronegative Individuals

Qin¹,

Nilsson

Sourial

et al. 2004

J Virol

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The mechanisms behind the resistance to human immunodeficiency virus type 2 (HIV-2) infection are still not fully understood. In the present study, we explored the HIV-2-specific humoral serum immunoglobulin A (IgA) immune response in HIV-2-exposed IgG-seronegative (EGSN) individuals. Serum samples from heterosexual EGSN individuals and their known HIV-2-infected partners, as well as controls originating from Guinea-Bissau in Africa, were studied. Antibody reactivity to native and recombinant envelope glycoproteins was investigated, and the capacity of purified serum IgA to neutralize HIV-2 SBL6669 was tested. Our results showed that 16 of 25 EGSN samples exhibited reactivity against whole HIV-2 antigen, 6 of 25 samples reacted with recombinant gp36 (rgp36), and 3 of 25 samples were positive against HIV-2 rgp105; no reactivity to native HIV-2 gp125 was detected. Purified serum IgA antibodies from both EGSN and HIV-2-positive individuals, but not that from the negative controls, exhibited neutralization of HIV-2 SBL6669 . The most potent neutralization activity was exhibited by IgA purified from EGSN compared to infected individuals' IgA. The antigenic pattern of the HIV-2-positive partners showed that all serum IgA samples were reactive to whole HIV-2 antigen, and 14 of 15 reacted with rgp36. For rgp105 and gp125, 5 of 15 and 4 of 15 samples exhibited binding, respectively. The serum of the EGSN group had a higher mean IgA concentration than that of the negative controls (P < 0.05). Thus, we describe HIV-2-specific serum IgA antigen reactivity and show a more potent serum IgAmediated HIV-2-neutralizing activity in EGSN individuals than in HIV-2-infected patients.

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Field evaluation of alternative testing strategies for diagnosis and differentiation of HIV-1 and HIV-2 infections in an HIV-1 and HIV-2-prevalent area

Cited by 79 publications

References 22 publications

Field Evaluation of a Rapid Human Immunodeficiency Virus (HIV) Serial Serologic Testing Algorithm for Diagnosis and Differentiation of HIV Type 1 (HIV-1), HIV-2, and Dual HIV-1-HIV-2 Infections in West African Pregnant Women

Field Evaluation of a Rapid Human Immunodeficiency Virus (HIV) Serial Serologic Testing Algorithm for Diagnosis and Differentiation of HIV Type 1 (HIV-1), HIV-2, and Dual HIV-1-HIV-2 Infections in West African Pregnant Women

Assessing Proficiency of Interpretation of Rapid Human Immunodeficiency Virus Assays in Nonlaboratory Settings: Ensuring Quality of Testing

Potent Neutralizing Serum Immunoglobulin A (IgA) in Human Immunodeficiency Virus Type 2-Exposed IgG-Seronegative Individuals

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