HIV serologically indeterminate individuals: Future HIV status and risk factors

Mwinnyaa, George; Grabowski, Mary Kathryn; Gray, Ronald H.; Wawer, Maria J.; Chang, Larry W.; Ssekasanvu, Joseph; Kagaayi, Joseph; Kigozi, Godfrey; Kalibbala, Sarah; Galiwango, Ronald M.; Ndyanabo, Anthony; Serwadda, David; Quinn, Thomas C.; Reynolds, Steven J.; Laeyendecker, Oliver

doi:10.1371/journal.pone.0237633

PLoS ONE

2020

DOI: 10.1371/journal.pone.0237633

|View full text |Cite

HIV serologically indeterminate individuals: Future HIV status and risk factors

George Mwinnyaa

Mary Kathryn Grabowski

Ronald H. Gray

et al.

Abstract: BackgroundIndeterminate HIV test results are common, but little is known about the evolution of indeterminate serology and its sociodemographic and behavioral correlates. We assessed future HIV serological outcomes for individuals with indeterminate results and associated factors in Rakai, Uganda. Methods115,944 serological results, defined by two enzyme immunoassay (EIAs), among 39,440 individuals aged 15-49 years in the Rakai Community Cohort Study were assessed. Indeterminate results were defined as contrad… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Citation Types

Supporting

Mentioning

Contrasting

Year Published

2023

2024

Publication Types

Select...

Article2

Relationship

Self Cite0

Independent2

Authors

Journals

Cited by 2 publications

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Characterization of Rare Spontaneous Human Immunodeficiency Virus Viral Controllers Attending a National United Kingdom Clinical Service Using a Combination of Serology and Molecular Diagnostic Assays

Khan

Bradshaw²,

Brown³

et al. 2023

Open Forum Infectious Diseases

View full text Add to dashboard Cite

We report outcomes and novel characterisation of a unique cohort of 42 individuals with persistently indeterminate HIV status, the majority of whom are HIV viral controllers. Eligible individuals had indeterminate or positive HIV serology, but persistently undetectable HIV RNA by commercial assays and were not taking ART. Routine investigations included: HIV Western blot; HIV viral load; qualitative HIV-1 DNA; co-infection screen and T-cell quantification. Research assays included T-cell activation; ART measurement; single copy assays detecting HIV-1 RNA and DNA and plasma cytokine quantification. HIV seropositivity was defined as ≥3 bands on Western blot; molecular positivity as detection of HIV RNA or DNA. HIV infection was excluded in 10/42 referrals, remains unconfirmed in 2/42 and was confirmed in 30/42, who were identified as HIV elite controllers (EC), normal CD4 T-cell counts (median 820/ml, range 805-1336) and normal CD4:CD8 ratio (median 1.8, range 1.2-1.9). ECs had a median duration of elite control of 6 years (IQR=4-14). ART was undetected in all 23 tested. Two distinct categories of EC were identified: molecular-positive (n=20) and molecular-negative (n=10). HIV status was resolved for 95% of referrals with the majority diagnosed as EC. The clinical significance of the two molecular categories amongst EC requires further investigation.

show abstract

Characterization of Rare Spontaneous Human Immunodeficiency Virus Viral Controllers Attending a National United Kingdom Clinical Service Using a Combination of Serology and Molecular Diagnostic Assays

Khan

Bradshaw²,

Brown³

et al. 2023

Open Forum Infectious Diseases

View full text Add to dashboard Cite

show abstract

Longitudinal patterns in indeterminate HIV rapid antibody test results: a population-based, prospective cohort study

Hunt,

Mwinnyaa,

Patel

et al. 2024

Microbiol Spectr

View full text Add to dashboard Cite

Rapid HIV tests are critical to HIV surveillance and universal testing and treatment programs. We assessed longitudinal patterns in indeterminate HIV rapid test results in an African population-based cohort. Prospective HIV rapid antibody test results, defined by two parallel rapid tests, among participants aged 15–49 years from three survey rounds of the Rakai Community Cohort Study, Uganda, from 2013 to 2018, were assessed. An indeterminate result was defined as any weak positive result or when one test was negative and the other was positive. A total of 31,405 participants contributed 54,459 person-visits, with 15,713 participants contributing multiple visits and 7,351 participants contributing 3 visits. The prevalence of indeterminate results was 2.7% (1,490/54,469). Of the participants with multiple visits who initially tested indeterminate ( n = 591), 40.4% were negative, 18.6% were positive, and 41.0% were indeterminate at the subsequent visit. Of the participants with two consecutive indeterminate results who had a third visit ( n = 67), 20.9% were negative, 9.0% were positive, and 70.2% remained indeterminate. Compared to a prior negative result, a prior indeterminate result was strongly associated with a subsequent indeterminate result [adjusted prevalence ratio, 23.0 (95% CI = 20.0–26.5)]. Compared to men, women were more likely to test indeterminate than negative [adjusted odds ratio, 2.3 (95% CI = 2.0–2.6)]. Indeterminate rapid HIV test results are highly correlated within an individual and 0.6% of the population persistently tested indeterminate over the study period. A substantial fraction of people with an indeterminate result subsequently tested HIV positive at the next visit, underscoring the importance of follow-up HIV testing protocols. IMPORTANCE Rapid HIV tests are a critical tool for expanding HIV testing and treatment to end the HIV epidemic. The interpretation and management of indeterminate rapid HIV test results pose a unique challenge for connecting all people living with HIV to the necessary care and treatment. Indeterminate rapid HIV test results are characterized by any weak positive result or discordant results (when one test is negative and the other is positive). We systematically tested all participants of a Ugandan population-based, longitudinal cohort study regardless of prior test results or HIV status to quantify longitudinal patterns in rapid HIV test results. We found that a substantial fraction (>15%) of participants with indeterminate rapid test results subsequently tested positive upon follow-up testing at the next visit. Our findings demonstrate the importance of follow-up HIV testing protocols for indeterminate rapid HIV test results.

show abstract

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

hi@scite.ai

334 Leonard St

Brooklyn, NY 11211

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Made with 💙 for researchers

Part of the Research Solutions Family.

HIV serologically indeterminate individuals: Future HIV status and risk factors

Cited by 2 publications

References 30 publications

Characterization of Rare Spontaneous Human Immunodeficiency Virus Viral Controllers Attending a National United Kingdom Clinical Service Using a Combination of Serology and Molecular Diagnostic Assays

Characterization of Rare Spontaneous Human Immunodeficiency Virus Viral Controllers Attending a National United Kingdom Clinical Service Using a Combination of Serology and Molecular Diagnostic Assays

Longitudinal patterns in indeterminate HIV rapid antibody test results: a population-based, prospective cohort study

Contact Info

Product

Resources

About