Sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays or HIV RNA tests

Tan, Wei; Chow, Eric P F; Fairley, Christopher K.; Chen, Marcus Y; Bradshaw, Catriona; Read, Tim

doi:10.1097/qad.0000000000001134

Cited by 27 publications

(19 citation statements)

References 37 publications

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“…A systematic review of HIV rapid test performance compared with fourth-generation HIV testing found a pooled sensitivity of 94.5% slightly higher than what was observed in our study. [17] This reduced sensitivity is concerning and more needs to be done to ensure greater accuracy of rapid HIV testing in these settings. In addition to continued implementation of quality assurance measures, the use of nucleic acid amplification tests for those who test rapid HIV test negative should also be considered.…”

Section: Discussionmentioning

confidence: 99%

The accuracy of HIV rapid testing in integrated bio-behavioral surveys of men who have sex with men across 5 Provinces in South Africa

et al. 2017

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We describe the accuracy of serial rapid HIV testing among men who have sex with men (MSM) in South Africa and discuss the implications for HIV testing and prevention.This was a cross-sectional survey conducted at five stand-alone facilities from five provinces.Demographic, behavioral, and clinical data were collected. Dried blood spots were obtained for HIV-related testing. Participants were offered rapid HIV testing using 2 rapid diagnostic tests (RDTs) in series. In the laboratory, reference HIV testing was conducted using a third-generation enzyme immunoassay (EIA) and a fourth-generation EIA as confirmatory. Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false-positive, and false-negative rates were determined.Between August 2015 and July 2016, 2503 participants were enrolled. Of these, 2343 were tested by RDT on site with a further 2137 (91.2%) having definitive results on both RDT and EIA. Sensitivity, specificity, positive predictive value, negative predictive value, false-positive rates, and false-negative rates were 92.6% [95% confidence interval (95% CI) 89.6–94.8], 99.4% (95% CI 98.9–99.7), 97.4% (95% CI 95.2–98.6), 98.3% (95% CI 97.6–98.8), 0.6% (95% CI 0.3–1.1), and 7.4% (95% CI 5.2–10.4), respectively. False negatives were similar to true positives with respect to virological profiles.Overall accuracy of the RDT algorithm was high, but sensitivity was lower than expected. Post-HIV test counseling should include discussions of possible false-negative results and the need for retesting among HIV negatives.

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Section: Discussionmentioning

confidence: 99%

The accuracy of HIV rapid testing in integrated bio-behavioral surveys of men who have sex with men across 5 Provinces in South Africa

et al. 2017

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“…The applicability of PCA analysis in segregating the spectral data set from recently infected plasma (spectra from intentionally contaminated plasma) and negative plasma was demonstrated as a potential HIV‐1 screening tool within the window period. The HIV‐1 p24 antigen within the plasma is normally detectable during the early stages of infection or before the seroconversion period . During pre‐seroconversion periods, HIV infection test targets HIV RNA and HIV provirus DNA, whereas some studies have targeted p24 antigen which is detectable in less than 14 days after initial exposure to the virus .…”

Section: Resultsmentioning

confidence: 99%

Estimation of HIV‐1 viral load in plasma of HIV‐1‐infected people based on the associated Raman spectroscopic peaks

Otange

Birech

Rop

et al. 2019

J Raman Spectroscopy

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Most HIV viral load determination techniques available commercially are anchored on direct measurements of either HIV ribonucleic acid (RNA), provirus DNA, or viral antigen. Such techniques often require expensive reagents which makes the process expensive. This study reported the feasibility of label‐free determination of HIV‐1 viral load in plasma based on the consequence of the virus in the components of plasma. The study aimed to provide a relatively cheap and faster HIV‐1 detection and further estimate the concentration of the virus without using any reagent. We subjected 22 HIV‐1‐infected human plasma samples to Raman peak height evaluation to develop a detection and concentration estimation model for HIV‐1. Simultaneously, all the samples were examined for HIV‐1 infection using qualitative polymerase chain reaction (PCR) test. The positive samples were further subjected to quantitative PCR to determine their corresponding viral load. Principal component analysis (PCA) and artificial neural network (ANN) were employed in Raman spectral analysis to enhance label‐free detection of the HIV‐1 in plasma. The quantification model results for HIV‐1 yielded a good correlation with those obtained by the reference quantitative PCR method. HIV‐1 viral load estimation based on the associated Raman spectral peaks centered at 1,270 and 1,446 cm−1 achieved a clinically accepted coefficient of determination (R2 > 0.9). The viral detection sensitivity from the two associated peaks were 95 and 100 copies of the virus per milliliter of plasma, respectively, hence showing that the Raman‐based model can be a potential HIV‐1 diagnostic and viral load estimation tool.

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“…Regarding the error rate of the PPG, previous research has demonstrated that the PPG can accurately discriminate between men convicted of sex offenses against children from those who have not (e.g., Barbaree & Marshall, ; Freund & Blanchard, ; Lalumiere & Quinsey, ; McPhail et al, ). No test is without its limitations; however, widely accepted medical tests (e.g., hematologic blood values, endocrinologic hormone levels, blood pressure measurements, HIV screening tests) develop cut scores that balance specificity and sensitivity (e.g., Tan et al, ; Waaler, ). Given the potentially significant legal ramifications of showing a deviant PPG response profile, along with maintaining the delicate legal balance between public safety and protecting the individual rights of the examinee, it is better to have more false negatives than false positives.…”

Section: Discussionmentioning

confidence: 99%

Use of penile plethysmography in the court: A review of practices in Canada, the United Kingdom and the United States

Murphy

Gottfried

DiMario

et al. 2020

Behavioral Sci & The Law

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Penile plethysmography (PPG) is an objective measure of male sexual arousal in response to the presentation of a series of erotic and neutral stimuli. This measure is now widely recognized as the most reliable means of objectively measuring male sexual arousal to specific stimuli. Many clinicians and researchers consider PPG to be a vital contribution to the assessment and treatment of adult men with paraphilic interests and men who have committed sex crimes. PPG contributes to the clinical assessment of paraphilic interests, appraisal of risk of recidivism, and provides an objective measurement of changes in sexual arousal in response to treatment. There is strong support for the utility of PPG within clinical and legal contexts. This article addresses ways in which PPG has been utilized in the courts as part of expert clinical opinion. History of its use, details regarding admissibility in court, and case law are explored within the legal systems of Canada, the UK and the USA. Support for the inclusion of PPG as expert evidence is provided and judicial misunderstandings on the rationale for PPG use and its clinical utility in forensic assessments are discussed.

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Sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays or HIV RNA tests

Cited by 27 publications

References 37 publications

The accuracy of HIV rapid testing in integrated bio-behavioral surveys of men who have sex with men across 5 Provinces in South Africa

The accuracy of HIV rapid testing in integrated bio-behavioral surveys of men who have sex with men across 5 Provinces in South Africa

Estimation of HIV‐1 viral load in plasma of HIV‐1‐infected people based on the associated Raman spectroscopic peaks

Use of penile plethysmography in the court: A review of practices in Canada, the United Kingdom and the United States

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