Biotin interferences: Have we neglected the impact on serological markers?

Detection of highly divergent HIV‐1 in clinical specimens using rapid HIV serologic assays

“…However, HIV genetic diversity is a significant concern with respect to virus diagnosis. In this study, detection of antibodies against HIV-1/2 was confirmed in a majority of the specimens from 3 However, this could not be verified in our study as there were no p24 antigen positive specimens detected using the Alere antigen/antibody rapid assay which is the only combo assay used, suggesting that the specimens in our collection were likely from patients with well-established HIV infection.…”

“…At the sampling date, the median age was 35 (range from 14 to 77 years old) and 70% were naïve of any antiretroviral treatment. The average HIV-1 RNA viral load was 86 445 copies/mL (range: <40-1 537 201 copies/mL) and the median CD4 cell count was 360/mm 3 Results of testing showed that depending on the RDTs used, antibodies against HIV-1/2 were detected in 97% to 99.7% of specimens previously shown to be antibody-positive ( Table 2). Testing of HIV negative specimens showed varying levels of specificity depending on the individual RDTs used and the results shown in Table 2.…”

“…1 Nevertheless, investigations have shown that the performance of RDTs may be challenged by various factors such as the genetic variability of HIV, coinfection or the presence of endogenous/exogenous substances. [2][3][4] Ongoing monitoring of commercial assays for HIV diagnosis is helpful and recommended, notably because of the increasing prevalence of divergent HIV-1 variants worldwide.…”

Ultrasensitive and Robust Point-of-Care Immunoassay for the Detection of Plasmodium falciparum Malaria

“…The uRDT uses a biotin–streptavidin test line capture system, which may improve the sensitivity of the lateral flow immunoassay by increasing the interaction time between the biotinylated capture antibody and the analyte . However, elevated blood biotin levels from supplement use can cause interference in immunoassays using the biotin–streptavidin system, and therefore, this system was not used in the UCNP-LF . Even though this uRDT shows a major improvement in sensitivity compared to conventional RDTs and can detect previously undetected infections, an even more sensitive rapid test is required for elimination settings.…”

“…27 However, elevated blood biotin levels from supplement use can cause interference in immunoassays using the biotin−streptavidin system, and therefore, this system was not used in the UCNP-LF. 28 Even though this uRDT shows a major improvement in sensitivity compared to conventional RDTs and can detect previously undetected infections, an even more sensitive rapid test is required for elimination settings. In a recent study of medium-endemic villages, the uRDT detected significantly more infections than the conventional RDT, but still missed 59% of the patients with gametocytes capable of infecting mosquitoes.…”