Pitfalls with rapid HIV antibody testing in HIV-infected children in the Western Cape, South Africa

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

“…However, we found the sensitivities of both tests to be slightly lower than reported and the sensitivity of Capillus to be lower than that of Determine (98.6% and 99.3%, respectively). Poor sensitivity has been reported elsewhere in sub-Saharan Africa (1,4). In contrast, we found the sensitivities of the Murex and Uniform II ELISA tests to be 100% and 99.3%, respectively.…”

“…Data from a number of evaluations suggest that the sensitivity and specificity of SR tests are similar to those of ELISA-and Western blotting-based algorithms (6,16). However, more recent studies have reported lower-than-expected sensitivities and specificities of SR tests (1,4). Therefore, for use in clinical trials, SR tests should be validated locally and undergo external quality assessment.…”

Young age a predictor of weak reactivity in a rapid antibody test in infants infected with HIV

“…Specific HIV antibody levels were determined by testing serially double-diluted serum specimens with a rapid assay of known relatively low sensitivity [Claassen et al, 2006], the Capillus TM HIV-1/HIV-2 rapid antibody test (Trinity Biotech plc, Bray Co. Wicklow, Ireland). Samples with a Capillus TM titer of 256 or higher were allocated to the High-Level group and samples with a titer of 4 or less, including falsenegatives, were allocated to the Low-Level group.…”

“…In a previous series [Claassen et al, 2006] two infants who were receiving ART did not have detectable HIV antibodies, even when tested with a laboratory-based third-generation enzyme immunoassay (EIA). The lack of antigenic stimulus due to suppression of retroviral replication through ART could have contributed to the absence of detectable antibodies in these patients [Desai et al, 2005].…”

“…In an article published recently absent or very low anti-HIV antibody reactivity in some infants infected with HIV, tested by two different HIV rapid tests, was described, leading to a high rate of false-negative results [Claassen et al, 2006]. As children infected with HIV are seldom found in the developed world, published data on the use of HIV rapid tests in this group is limited.…”