Use of rapid HIV antibody testing for controlling the HIV pandemic

Granade, Timothy C.

doi:10.1586/14787210.3.6.957

Cited by 12 publications

(4 citation statements)

References 50 publications

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“…The delivery of health care at the most peripheral levels of the health system plays an increasingly critical role in further scaling-up ART and forms a cornerstone of the UNAIDS 90-90-90 strategy. HIV viral load testing at the POC may also extend test access to settings where conventional laboratory assays are not easily accessible (11,12). POC viral load tests may also facilitate the delivery of viral load-informed differentiated care for ART patients (13).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Whole-Blood Alere Q NAT Point-of-Care RNA Assay for HIV-1 Viral Load Monitoring in a Primary Health Care Setting in Mozambique

et al. 2016

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Viral load testing is the WHO-recommended monitoring assay for patients on HIV antiretroviral therapy (ART). Point-of-care(POC) assays may help improve access to viral load testing in resource-limited settings. We compared the performance of the Alere Q NAT POC viral load technology (Alere Technologies, Jena, Germany), measuring total HIV RNA using finger prick capillary whole-blood samples collected in a periurban health center, with that of a laboratory-based plasma RNA test (Roche Cobas Ampliprep/Cobas TaqMan v2) conducted on matched venous blood samples. The whole-blood Alere Q NAT POC assay produced results with a bias of 0.8593 log copy/ml compared to the laboratory-based plasma assay. However, at above 10,000 copies/ ml, the bias was 0.07 log copy/ml. Using the WHO-recommended threshold to determine ART failure of 1,000 copies/ml, the sensitivity and specificity of the whole-blood Alere Q NAT POC assay were 96.83% and 47.80%, respectively. A cutoff of 10,000 copies/ml of whole blood with the Alere Q NAT POC assay appears to be a better predictor of ART failure threshold (1,000 copies/ml of plasma), with a sensitivity of 84.0% and specificity of 90.3%. The precision of the whole-blood Alere Q NAT POC assay was comparable to that observed with the laboratory technology (5.4% versus 7.5%) between detectable paired samples. HIV POC viral load testing is feasible at the primary health care level. Further research on the value of whole-blood viral load to monitor antiretroviral therapy is warranted. The World Health Organization strongly recommends the use of viral load testing as the primary tool for HIV antiretroviral treatment (ART) monitoring in its 2015 consolidated ART guidelines (1). The Joint United Nations Programme on HIV/AIDS (UNAIDS) has also highlighted the importance of viral load testing in its new 90-90-90 HIV targets and has launched a global initiative to increase access to viral load and other HIV diagnostic tests (2, 3). However, many resource-limited countries face challenges in implementing HIV viral load testing within their public health programs due to limited laboratory infrastructure, capacity, and skills. Emerging point-of-care (POC) technologies offer the opportunity to decentralize diagnostic testing and greatly expand access to quality health care (4).Plasma-based RNA constitutes the conventional gold standard specimen type and biomarker for HIV viral load measurement. Currently, however, plasma-based testing requires venipuncture and processing of blood specimens using centrifugation to separate plasma, which require some laboratory infrastructure. The use of finger or heel prick capillary blood samples increases the ease of use of POC tests and enables both sample collection and viral load testing to be decentralized to locations that lack laboratories, required infrastructure, or skilled technicians.The use of whole blood, although operationally advantageous, presents a technical problem, since both intracellular and extracellular RNA and DNA are present in the specimen and mig...

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Whole-Blood Alere Q NAT Point-of-Care RNA Assay for HIV-1 Viral Load Monitoring in a Primary Health Care Setting in Mozambique

et al. 2016

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“…Rapid HIV tests have been used in developing countries, where laboratory facilities are scarce, 5 and in settings where the population is hard to reach and few patients return for their results. 6,7 In 2006, a study among users of VCT sites in Catalonia was performed to assess the acceptability of introducing rapid testing in these centres.…”

Section: Introductionmentioning

confidence: 99%

Impact of the introduction of rapid HIV testing in the Voluntary Counselling and Testing sites network of Catalonia, Spain

Fernàndez‐López

Rifà

Pujol³

et al. 2010

Int J STD AIDS

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Rapid HIV antibody tests, which provide results within 15-60 minutes, can help reduce the number of unrecognized infections by improving access to testing facilities and increase the number of people tested who know their results. After an acceptability study, rapid HIV testing was first implemented in Catalonia in 2007 within the community-based Voluntary Counselling and Testing sites network. One year after implementation, an increase of 102.9% has been observed in the number of tests performed, ranging from 8.4% to 328.3% according to the site. Despite the important immediate impact of rapid HIV testing on the number of tests performed, there was no significant change in the proportion of tests that were positive. Rapid HIV testing can help increase access to testing, but it should be complemented with specific outreach programmes targeting the most vulnerable subgroups.

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“…Thus, both negative and positive results can be reported on the day and site of testing [Kassler et al, 1998], and the patient can receive immediate counseling, which may encourage adoption of risk-reducing behaviors. This potentially increases the number of individuals who get access to testing and who can thereby be offered clinical follow-up and treatment, if necessary [Palmer et al, 1999;Ekwueme et al, 2003;Galvan et al, 2004;Rouet et al, 2004;Granade, 2005;Morin et al, 2006]. Some recent improvements in simple/rapid tests include the ability to test whole blood specimens (in addition to serum or plasma) and storage at ambient temperatures (usually up to þ308C) [WHO/ UNAIDS, 2004].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the performance of rapid HIV tests using samples collected for surveillance in Mozambique

Melo

Nilsson

Mondlane

et al. 2009

Journal of Medical Virology

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Use of rapid HIV antibody testing for controlling the HIV pandemic

Cited by 12 publications

References 50 publications

Evaluation of the Whole-Blood Alere Q NAT Point-of-Care RNA Assay for HIV-1 Viral Load Monitoring in a Primary Health Care Setting in Mozambique

Evaluation of the Whole-Blood Alere Q NAT Point-of-Care RNA Assay for HIV-1 Viral Load Monitoring in a Primary Health Care Setting in Mozambique

Impact of the introduction of rapid HIV testing in the Voluntary Counselling and Testing sites network of Catalonia, Spain

Comparison of the performance of rapid HIV tests using samples collected for surveillance in Mozambique

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