Use of Point-of-Care Nucleic Acid Tests Beyond Early Infant Diagnosis of HIV: A Retrospective Case Review in Lesotho.

Journal of Acquired Immune Deficiency Syndromes : JAIDS
Kenneth MacnealJennifer Cohn

Abstract

Rapid diagnostic tests (RDTs) for HIV antibodies remain the primary method of diagnosis of HIV in individuals over age 18 months in Lesotho. Although antibody tests have high sensitivity and specificity, up to 2.3% of serial two-test algorithms can have discrepant results between RDTs. In the case of inconclusive RDT results, Lesotho guidelines at the time of this study recommended either repeat testing with the same RDT algorithm after 14 days or immediately collect a blood sample to be sent for laboratory-based polymerase chain reaction testing. Point-of-care qualitative nucleic acid tests (POC qual NAT) may have benefits in rapidly resolving these inconclusive results, particularly when compared with repeating RDTs later or conventional polymerase chain reaction testing at the National Reference Laboratory. Hospitals and clinics at 29 locations throughout Lesotho that had access to point-of-care nucleic acid testing. Retrospective case review. We identified 100 testing records where POC qual NAT was used to resolve inconclusive RDTs per Lesotho guidelines. Eighty-nine percent of patients received their results in a median of one day from their inconclusive RDT result (interquartile range 0-7 days). Sixty-eight patients (68%)...Continue Reading

References

Oct 31, 2009·International Journal of STD & AIDS·D MatemoJ Kiarie
Feb 5, 2010·Journal of Clinical Microbiology·Dramane KaniaUNKNOWN WHO/ANRS 1289 Kesho Bora Study Group in Burkina Faso
Apr 12, 2011·Journal of the International AIDS Society·Debrah I BoerasSusan Allen
Jan 30, 2014·PloS One·Catherine G SutcliffeWilliam J Moss
Sep 6, 2018·Open Forum Infectious Diseases·Anne M NeilanAndrea L Ciaranello

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