Does antiretroviral therapy use affect the accuracy of HIV rapid diagnostic assays? Experience from a demographic health and surveillance site in rural South Africa.,Diagnostic Microbiology and Infectious Disease

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Does antiretroviral therapy use affect the accuracy of HIV rapid diagnostic assays? Experience from a demographic health and surveillance site in rural South Africa.
Diagnostic Microbiology and Infectious Disease ( IF 2.1 ) Pub Date : 2020-03-02 , DOI: 10.1016/j.diagmicrobio.2020.115031
Mark J Siedner ₁ , Kathy Baisley ₂ , Olivier Koole ₂ , Innocentia Mpofana ₃ , Gregory Ording-Jespersen ₃ , Philippa Matthews ₃ , Kobus Herbst ₃ , Theresa Smit ₃ , Deenan Pillay ₄

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Rapid diagnostic tests (RDTs) are the mainstay of HIV diagnosis in the developing world but might have poor sensitivity among individuals taking antiretroviral therapy (ART). We leveraged a home-based HIV testing program linked to clinical data to compare the sensitivity of RDTs between individuals using versus not using ART. Field workers tested 6802 individuals using 2 HIV RDTs, which were compared to a single HIV immunoassay tested on dried blood spots. Approximately 5% (371/6802) tested positive by immunoassay, of whom 157 (42%) were currently on ART. The sensitivity of the Abon RDT among those never versus currently on ART was 91.6% (95% CI 88.3-94.3) and 96.6% (95% CI 88.3-94.3), respectively, and 95.4% (95% CI 92.8-97.3) versus 99.3% (95% CI 95.2-99.7) for the Advanced Quality assay. We report similar sensitivity of RDTs in ART-naïve and ART-experienced individuals, which mitigates concerns about their use among treated individuals in population-based epidemiologic surveys and those transferring care.

更新日期：2020-04-20

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