Re‐testing and misclassification of HIV‐2 and HIV‐1&amp;2 dually reactive patients among the HIV‐2 cohort of The West African Database to evaluate AIDS collaboration

Tchounga, Boris; Inwoley, André; Coffie, Patrick A.; Minta, D.K.; Messou, Eugène; Bado, Guillaume; Minga, Albert; Hawerlander, Denise; Kane, Coumba Touré; Eholié, Serge; Dabis, François; Ekouévi, Didier K.

doi:10.7448/ias.17.1.19064

Cited by 26 publications

(32 citation statements)

References 34 publications

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“…Thus, with a low rate of transmission, compare to HIV-1, HIV-2 infects old people aged more than 40 years old [17] [24]. This finding was confirmed in our study where the mean age was 43.5 years and 65.0% of HIV-2 infected patients were at least 40 years old.…”

Section: Discussionsupporting

confidence: 87%

Trends in HIV-2 Seroprevalence at the National Reference Center of HIV from 2005 to 2014 in Lome, Togo

Ehlan¹,

Salou²,

Kolou³

et al. 2017

WJA

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Background: In Togo, the HIV/AIDS epidemic is characterized by the circulation of the 2 subtypes of HIV. Thus, patients infected with HIV-2 are diagnosed and monitored in the care centers. Objective: To document the trend of HIV-2 prevalence over a decade of activities of the National Reference Center for HIV tests and screening (CNR-VIH). Methods: A cross sectional study was carried out from the screening data archived from January 2005 to December 2014 at the CNR-VIH, a laboratory located in the Sylvanus Olympio University Hospital (CHU SO) Lome. The sampling consisted of adults and children outpatients or those who were hospitalized in CHU SO, subjects presenting for voluntary testing, pregnant women and patients or samples referred for HIV confirmation. All samples were tested for HIV-1 and HIV-2 infections by combining ELISA and rapid diagnostic tests. Result: During the decade, 34,077 subjects were screened for HIV infection. The overall prevalence of HIV infection was 20.70% (7055/34077). In 10 years, the prevalence of HIV infection in CNR-VIH decreased significantly from 35.40% CI 95% [34.50% -36.20%] in 2005 to 14.20% CI 95% [13.60% -14.70%] in 2014 (p = 0.03). The prevalence of HIV-1, HIV-2 and dual HIV1&HIV-2 was respectively 20.40%, 0.23% and 0.07%, with annual prevalence of HIV-2 between 0.07% and 0.39%. The differences between the HIV-2 prevalence over the decade were not statistically significant (p > 0.15). A 4-year-old child from mother-to-child HIV-2 transmission was diagnosed. Sixty-five percent of adult patients were over 40 years of age with an average age of 43.5 ± 11. Togo over the last ten years confirm the existence of a weak epidemic of HIV-2 infection with a tendency towards stability.

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Section: Discussionsupporting

confidence: 87%

Trends in HIV-2 Seroprevalence at the National Reference Center of HIV from 2005 to 2014 in Lome, Togo

Ehlan¹,

Salou²,

Kolou³

et al. 2017

WJA

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“…Most studies were carried out in Africa ( n = 48) [5,7,10–14,16,22–25,29,30,32–34,36,37,39,41,43,44,46,47,49,51,52,54–59,61–65,67–72,74,75], followed by in the Americas ( n = 7) [28,31,42,50,53,60,66], Asia ( n = 4) [8,35,45,73] and Europe ( n = 1) [48]. There were also four multi-country/regional studies [26,27,38,40].…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-seven studies reported using a suboptimal testing strategy that differed from the WHO recommendations [5,8,11–14,16,22–30,32–34,36–39,42–44,49,51,53,59,62,64–66,68,72,75]. Suboptimal testing strategies included using a highly specific first-line test and highly sensitive second-line test [14,33,39,55], using a single RDT for HIV-positive diagnoses [11,66,72], using a high prevalence testing strategy in a low prevalence setting [16,49], using a parallel testing algorithms and a tiebreaker testing strategy (where a third assay is used to resolve discrepant test results and rule in HIV infection) [5,12,13,16,24,25,27–30,32,34,36,37,68].…”

Section: Resultsmentioning

confidence: 99%

To err is human, to correct is public health: a systematic review examining poor quality testing and misdiagnosis of HIV status

Johnson

Fonner

Sands

et al. 2017

Journal of the International AIDS Society

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Introduction: In accordance with global testing and treatment targets, many countries are seeking ways to reach the “90-90-90” goals, starting with diagnosing 90% of all people with HIV. Quality HIV testing services are needed to enable people with HIV to be diagnosed and linked to treatment as early as possible. It is essential that opportunities to reach people with undiagnosed HIV are not missed, diagnoses are correct and HIV-negative individuals are not inadvertently initiated on life-long treatment. We conducted this systematic review to assess the magnitude of misdiagnosis and to describe poor HIV testing practices using rapid diagnostic tests. Methods: We systematically searched peer-reviewed articles, abstracts and grey literature published from 1 January 1990 to 19 April 2017. Studies were included if they used at least two rapid diagnostic tests and reported on HIV misdiagnosis, factors related to potential misdiagnosis or described quality issues and errors related to HIV testing. Results: Sixty-four studies were included in this review. A small proportion of false positive (median 3.1%, interquartile range (IQR): 0.4-5.2%) and false negative (median: 0.4%, IQR: 0-3.9%) diagnoses were identified. Suboptimal testing strategies were the most common factor in studies reporting misdiagnoses, particularly false positive diagnoses due to using a “tiebreaker” test to resolve discrepant test results. A substantial proportion of false negative diagnoses were related to retesting among people on antiretroviral therapy. Conclusions: HIV testing errors and poor practices, particularly those resulting in false positive or false negative diagnoses, do occur but are preventable. Efforts to accelerate HIV diagnosis and linkage to treatment should be complemented by efforts to improve the quality of HIV testing services and strengthen the quality management systems, particularly the use of validated testing algorithms and strategies, retesting people diagnosed with HIV before initiating treatment and providing clear messages to people with HIV on treatment on the risk of a “false negative” test result.

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“…The diagnosis of dual HIV infection remains difficult without the measurement of both viruses by PCR and the appropriate detection algorithms when using a serological testing Tchounga et al 2014. Immunological and virological follow-up of both HIV-1 and HIV-2 in dually seropositive patients is recommended.…”

Section: Resultsmentioning

confidence: 98%

Update on HIV-1 and HIV-2 Dual Infection

Ekouévi

Eholié

2013

Encyclopedia of AIDS

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Re‐testing and misclassification of HIV‐2 and HIV‐1&2 dually reactive patients among the HIV‐2 cohort of The West African Database to evaluate AIDS collaboration

Cited by 26 publications

References 34 publications

Trends in HIV-2 Seroprevalence at the National Reference Center of HIV from 2005 to 2014 in Lome, Togo

Trends in HIV-2 Seroprevalence at the National Reference Center of HIV from 2005 to 2014 in Lome, Togo

To err is human, to correct is public health: a systematic review examining poor quality testing and misdiagnosis of HIV status

Update on HIV-1 and HIV-2 Dual Infection

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