HIV Nucleic Acid Amplification Testing Versus Rapid Testing

O’Neal, Joshua D.; Golden, Matthew R.; Branson, Bernard M.; Stekler, Joanne D.

doi:10.1097/qai.0b013e31825aab51

Cited by 12 publications

(10 citation statements)

References 33 publications

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“…Programs should, of course, consider whether the target population has a preference. However, our experience suggests caution in making assumptions, as our work has shown that MSM and transgender persons familiar with HIV testing may prefer oral fluid as a specimen collection method but have more trust in the ability of tests performed on venipuncture specimens to provide accurate results [20]. Finally, one must consider the financial resources and priorities of the program.…”

Section: Discussionmentioning

confidence: 99%

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Performance of Determine Combo and other point-of-care HIV tests among Seattle MSM

Stekler

Ure

O’Neal

et al. 2016

Journal of Clinical Virology

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Background and Objective The Rapid Test Study was a real-time comparison of point-of-care (POC) HIV tests to determine their abilities to detect early HIV infection. Study Design Men and transgender persons reporting sex with men in the prior year were recruited at the Public Health – Seattle & King County STD Clinic, Gay City Health Project, and University of Washington Primary Infection Clinic. Study tests included the OraQuick ADVANCE Rapid HIV-1/2 Antibody Test performed on oral fluids and tests performed on fingerstick whole blood specimens including OraQuick, Uni-Gold Recombigen HIV Test, Determine HIV-1/2 Ag/Ab Combo, and INSTI HIV-1 Rapid Antibody Test. Specimens from subjects with negative results were sent for EIA and nucleic acid amplification testing. McNemar's exact tests compared the numbers of HIV-infected subjects detected. Results Between February 2010 and August 2014, there were 3438 study visits. Twenty-four subjects had discordant POC results with at least one reactive and one non-reactive test, including one subject with a reactive Determine p24 antigen. OraQuick performed on oral fluids identified fewer persons compared to all fingerstick tests. OraQuick performed on fingerstick whole blood detected fewer persons compared to the Determine Combo antibody component (p=.008) and Combo overall (p=.004), and there was a trend when compared to INSTI (p=.06). The Determine Combo specificity was 98.99%. Conclusions As reported by others, Determine Combo underperforms compared to laboratory-based testing, but it did detect one acute infection. If these results are validated, the specificity of Determine Combo may limit its usefulness in populations with lower HIV incidence.

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Section: Discussionmentioning

confidence: 99%

“…In 2010, we began a prospective, cross-sectional study to compare the ability of different POC and laboratory-based HIV tests, all performed on fresh specimens from the same individuals, to detect acute and early infection in real-time [20, 21]. This report describes the final findings from the project.…”

Section: Objectivesmentioning

confidence: 99%

Performance of Determine Combo and other point-of-care HIV tests among Seattle MSM

Stekler

Ure

O’Neal

et al. 2016

Journal of Clinical Virology

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“…HIV screening procedures are described elsewhere [6-8]. Oral fluid was collected using a flocked swab (Copan Diagnostics) rubbed twice in the buccal sulcus between the top and bottom teeth and gums and inserted into a 2-mL cryovial.…”

Section: Methodsmentioning

confidence: 99%

“…Beginning in 2001, several health departments created pooled nucleic acid amplification testing (NAAT) programs to increase acute infection case-finding [2-5]. However, there are barriers to widespread implementation of HIV-1 NAAT, including the fact that high risk persons prefer less invasive specimen collection methods over venipuncture [6]. In developing countries, needs for venipuncture, sample storage, and advanced technology are other potential barriers.…”

Section: Introductionmentioning

confidence: 99%

“…In 2010, we began a prospective, cross-sectional study to compare the ability of point-of-care (POC) and laboratory-based HIV-1 tests to detect acute and early infection in real-time [6-8]. This report describes findings from a pilot substudy to evaluate the performance of NAAT on non-venipuncture specimens that could be collected at home or other settings without immediate access to NAAT.…”

Section: Introductionmentioning

confidence: 99%

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Detection of HIV RNA in dried blood spots and oral fluids

Stekler

Ure²,

Dragavon³

et al. 2017

Aids

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We evaluated detection of HIV-1 RNA from dried blood spots (DBS) and oral fluid specimens. Between February 2010 and August 2014, HIV-1 was newly diagnosed in eight (2.6%) subjects who had median blood HIV-1 RNA of 61,500 copies/mL (IQR 7500-146,000). RNA was detected in 7 (87.5%) DBS and 3 (37.5%) oral fluid swabs but was not detected in either specimen from one participant. DBS may be a reasonable specimen collection method to detect acute infection.

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Individualized diagnosis interventions can add significant effectiveness in reducing human immunodeficiency virus incidence among men who have sex with men: insights from Southern California

Khanna

Goodreau

Wohlfeiler

et al. 2015

Annals of Epidemiology

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Purpose In this paper, we examine the effectiveness of a variety of HIV diagnosis interventions that utilize the preventive potential of post-diagnosis behavior change (PDBC) in recently HIV-diagnosed men who have sex with men (MSM), as measured by reduction in number of new infections. Empirical evidence for PDBC was presented in the behavioral sub-study of the Southern California Acute Infection and Early Disease Research Program (AIEDRP). In previous modeling work, we demonstrated the existing preventive effects of PDBC. However, a large proportion of new infections among MSM are either undiagnosed or diagnosed late, and the preventive potential of PDBC is not fully utilized. Methods We derive empirical stochastic, network-based models to examine the effectiveness over a 10 year period of several diagnosis interventions that account for PDBC among MSM. These interventions involve tests with shorter detection windows, more frequent testing, and individualized testing regimens. Results We find that individualized testing interventions (i.e. testing individuals every 3 partners or 3 months, whichever is first, or every 6 partners or 6 months, whichever is first) result in significantly fewer new HIV infections than the generalized interventions we consider. Conclusions This work highlights the potential of individualized interventions for new public health policies in HIV prevention.

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HIV Nucleic Acid Amplification Testing Versus Rapid Testing

Cited by 12 publications

References 33 publications

Performance of Determine Combo and other point-of-care HIV tests among Seattle MSM

Performance of Determine Combo and other point-of-care HIV tests among Seattle MSM

Detection of HIV RNA in dried blood spots and oral fluids

Individualized diagnosis interventions can add significant effectiveness in reducing human immunodeficiency virus incidence among men who have sex with men: insights from Southern California

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