Evaluation of current rapid HIV test algorithms in Rakai, Uganda
Journal of Virological Methods
Rakai Health Sciences Program, Kalisizo, Uganda; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Laboratory of Immunoregulation, Division of Intramural Research, NIAID National Institutes of Health, Bethesda, MD, United States; Makerere College of Health Sciences, School of Public Health, Kampala, Uganda; Johns Hopkins University, School of Medicine, United States
Rapid HIV tests are a crucial component of HIV diagnosis in resource limited settings. In Uganda, the Ministry of Health allows both serial and parallel HIV rapid testing using Determine, Stat-Pak and Uni-Gold. In serial testing, a non-reactive result on Determine ends testing. The performance of serial and parallel algorithms with Determine and Stat-Pak test kits was assessed. A cross-sectional diagnostic test accuracy evaluation using three rapid HIV test kits as per the recommended parallel test algorithm was followed by EIA-WB testing with estimates of the performance of serial testing algorithm. In 2520 participants tested by parallel rapid algorithms, 0.6% had weakly reactive result. Parallel testing had 99.7% sensitivity and 99.8% specificity. If Stat-Pak was used as the first screening test for a serial algorithm, the sensitivity was 99.6% and specificity was 99.7%. However, if Determine was used as the screening test, sensitivity was 97.3% and specificity was 99.9%. Serial testing with Stat-Pak as the initial screening test performed as well as parallel testing, but Determine was a less sensitive screen. Serial testing could be cost saving. © 2013 Elsevier B.V.
adolescent; adult; age distribution; algorithm; article; controlled study; cost control; cross-sectional study; diagnostic accuracy; diagnostic test accuracy study; enzyme linked immunosorbent assay; female; high risk population; HIV rapid test; human; Human immunodeficiency virus infection; infection risk; major clinical study; male; predictive value; priority journal; screening test; sensitivity and specificity; Uganda; Western blotting; Adolescent; Adult; Algorithms; Diagnostic Tests, Routine; Female; HIV Infections; Humans; Male; Middle Aged; Sensitivity and Specificity; Uganda; Young Adult