A Commitment to HIV Diagnostic Accuracy - a comment on "Towards more accurate HIV testing in sub-Saharan Africa: a multi-site evaluation of HIV RDTs and risk factors for false positives 'and' HIV misdiagnosis in sub-Saharan Africa: a performance of diagnostic algorithms at six testing sites"

Journal of the International AIDS Society
Amy S Kravitz Del SolarJohn Nkengasong

Abstract

As part of the global response to the HIV/AIDS epidemic, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is committed to the provision of high-quality services and ensuring testing accuracy. Two recently published papers focusing on HIV testing and misdiagnosis in sub-Saharan Africa by Kosack et al. report on evaluations of HIV rapid diagnostic tests (RDTs) and found lower than expected specificity and sensitivity on some tests when used in certain geographic locations. The magnitude of PEPFAR's global HIV response has been possible due to the extensive use of RDTs, which have made HIV diagnosis accessible all over the world. We take the opportunity to address concerns raised about the potential implications that these findings could have on real-world HIV testing accuracy. PEPFAR supported countries adhere to the normative guidance by World Health Organization (WHO) supporting algorithms which require sequential positive tests for diagnostic accuracy. An analysis of Médecins Sans Frontières (MSF) RDT site-specific data applied to PEPFAR in-country protocols demonstrate a variation in the diagnostic accuracy of the testing algorithms, but with a very small population-level effect. The data demonstrate, with the use...Continue Reading

References

Nov 5, 1997·Science
Jul 3, 2008·AIDS Research and Human Retroviruses·Soumya SwaminathanKaustuv Nayak
Sep 22, 2010·American Journal of Clinical Pathology·Bharat S ParekhJohn N Nkengasong
Jan 11, 2014·Expert Review of Anti-infective Therapy·Derryck KlarkowskiKasha P Singh
Jul 12, 2017·Journal of the International AIDS Society·Cara S KosackAnne-Laure Page
Sep 6, 2017·Journal of the International AIDS Society·Cheryl C JohnsonRachel Baggaley

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Citations

Jul 2, 2019·PloS One·Arielle LasryStephanie Behel
Aug 14, 2020·PloS One·Feliciana Lage de Oliveira MarinhoLeonardo de Souza Vasconcellos

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Methods Mentioned

BETA
ELISA
Assay

Software Mentioned

PEPFAR

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