1921
Volume 101, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Detection of acute HIV infection is a unique problem that fourth-generation HIV assays were expected to alleviate. In this commentary, we draw attention to the limitations and challenges with use of currently available rapid antigen–antibody (Ag/Ab) combination tests for detection of acute HIV infection in sub-Saharan Africa. Laboratory-based HIV-1 Ag/Ab immunoassays are complex, requiring specialized equipment and handling that are currently not affordable in many settings in Africa. The point-of-care Ag/Ab platform on the other hand is easier to deploy and potentially more accessible in resource-limited settings. However, available fourth-generation HIV-1 rapid diagnostic tests have demonstrated poor performance characteristics in field studies where non-B subtypes of HIV-1 dominate. The potential for point-of-care HIV-1 Ag/Ab diagnostics to significantly improve detection of acute HIV infection remains yet to be realized in sub-Saharan Africa. Assay platforms need to be optimized to identify local circulating subtypes, and optimal algorithms need to be determined.

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References

  1. Patel P et al., 2010. Detecting acute human immunodeficiency virus infection using 3 different screening immunoassays and nucleic acid amplification testing for human immunodeficiency virus RNA, 2006-2008. Arch Intern Med 170: 6674.
    [Google Scholar]
  2. Livant E et al., 2017. The fourth generation Alere™ HIV Combo rapid test improves detection of acute infection in MTN-003 (VOICE) samples. J Clin Virol 94: 1521.
    [Google Scholar]
  3. Wawer MJ et al., 2005. Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda. J Infect Dis 191: 14031409.
    [Google Scholar]
  4. Sanders EJ, Mugo P, Prins HA, Wahome E, Thiong’o AN, Mwashigadi G, van der Elst EM, Omar A, Smith AD, Graham SM, 2014. Acute HIV-1 infection is as common as malaria in young febrile adults seeking care in coastal Kenya. AIDS 28: 13571363.
    [Google Scholar]
  5. Nasrullah M, Wesolowski LG, Meyer WA 3rd, Owen SM, Masciotra S, Vorwald C, Becker WJ, Branson BM, 2013. Performance of a fourth-generation HIV screening assay and an alternative HIV diagnostic testing algorithm. AIDS 27: 731737.
    [Google Scholar]
  6. Bennett B, Neumann D, Fordan S, Villaraza R, Crowe S, Gillis L, 2013. Performance of the new HIV-1/2 diagnostic algorithm in Florida’s public health testing population: a review of the first five months of utilization. J Clin Virol 58 (Suppl 1): e29e33.
    [Google Scholar]
  7. Masciotra S, Luo W, Youngpairoj AS, Kennedy MS, Wells S, Ambrose KM, Sprinkle PS, Owen SM, 2013. Performance of the Alere Determine™ HIV-1/2 Ag/Ab Combo Rapid Test with specimens from HIV-1 seroconverters from the US and HIV-2 infected individuals from Ivory Coast. J Clin Virol 58 (Suppl 1): e54e58.
    [Google Scholar]
  8. Conway DP, Holt M, McNulty A, Couldwell DL, Smith DE, Davies SC, Cunningham P, Keen P, Guy R, Sydney Rapid HIV Test Study, 2014. Multi-centre evaluation of the Determine HIV Combo assay when used for point of care testing in a high-risk clinic-based population. PLoS One 9: e94062.
    [Google Scholar]
  9. Duong YT et al., 2014. Poor performance of the determine HIV-1/2 Ag/Ab combo fourth-generation rapid test for detection of acute infections in a National Household Survey in Swaziland. J Clin Microbiol 52: 37433748.
    [Google Scholar]
  10. Brauer M, De Villiers JC, Mayaphi SH, 2013. Evaluation of the Determine™ fourth generation HIV rapid assay. J Virol Methods 189: 180183.
    [Google Scholar]
  11. Rosenberg NE et al., 2012. Detection of acute HIV infection: a field evaluation of the Determine® HIV-1/2 Ag/Ab combo test. J Infect Dis 205: 528534.
    [Google Scholar]
  12. Lewis JM, Macpherson P, Adams ER, Ochodo E, Sands A, Taegtmeyer M, 2015. Field accuracy of fourth-generation rapid diagnostic tests for acute HIV-1: a systematic review. AIDS 29: 24652471.
    [Google Scholar]
  13. Bhowan K, Kalk E, Khan S, Sherman G, 2011. Identifying HIV infection in South African women: how does a fourth generation HIV rapid test perform? Afr J Lab Med 1: 4.
    [Google Scholar]
  14. Centers for Disease Control and Prevention and Association of Public Health Laboratories, 2018. Laboratory testing for the diagnosis of HIV infection: updated recommendations. Available at: http://www.cdc.gov/hiv/pdf/hivtestingalgorithmrecommendation-final.pdf. Accessed September 22, 2018.
  15. McRae B, Lange J, Ascher M, De Wolf F, Sheppard H, Goudsmit J, Allain JP, 1991. Immune response to HIV p24 core protein during the early phases of human immunodeficiency virus infection. AIDS Res Hum Retroviruses 7: 637643.
    [Google Scholar]
  16. Pavie J et al., 2010. Sensitivity of five rapid HIV tests on oral fluid or finger-stick whole blood: a real-time comparison in a healthcare setting. PLoS One 5: e11581.
    [Google Scholar]
  17. Meier T, Knoll E, Henkes M, Enders G, Braun R, 2001. Evidence for a diagnostic window in fourth generation assays for HIV. J Clin Virol 23: 113116.
    [Google Scholar]
  18. Speers D, Phillips P, Dyer J, 2005. Combination assay detecting both human immunodeficiency virus (HIV) p24 antigen and anti-HIV antibodies opens a second diagnostic window. J Clin Microbiol 43: 53975399.
    [Google Scholar]
  19. Apetrei C, Loussert-Ajaka I, Descamps D, Damond F, Saragosti S, Brun-Vezinet F, Simon F, 1996. Lack of screening test sensitivity during HIV-1 non-subtype B seroconversions. AIDS 10: 5760.
    [Google Scholar]
  20. Lihana RW, Ssemwanga D, Abimiku A, Ndembi N, 2012. Update on HIV-1 diversity in Africa: a decade in review. AIDS Reviews 14: 83100.
    [Google Scholar]
  21. Hemelaar J, Gouws E, Ghys PD, Osmanov S, WHO-UNAIDS Network for HIV Isolation and Characterisation, 2011. Global trends in molecular epidemiology of HIV-1 during 2000-2007. AIDS 25: 679689.
    [Google Scholar]
  22. Krajden M, Cook D, Mak A, Chu K, Chahil N, Steinberg M, Rekart M, Gilbert M, 2014. Pooled nucleic acid testing increases the diagnostic yield of acute HIV infections in a high-risk population compared to 3rd and 4th generation HIV enzyme immunoassays. J Clin Virol 61: 132137.
    [Google Scholar]
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  • Received : 16 Feb 2019
  • Accepted : 22 Apr 2019
  • Published online : 03 Jun 2019
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