Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations

HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been rep...

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Vydané v:	PloS one Ročník 12; číslo 7; s. e0180796
Hlavní autori:	Harbertson, Judith, Hale, Braden R., Tran, Bonnie R., Thomas, Anne G., Grillo, Michael P., Jacobs, Marni B., McAnany, Jennifer, Shaffer, Richard A.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Public Library of Science 07.07.2017 Public Library of Science (PLoS)
Predmet:	Accuracy Acquired immune deficiency syndrome Adhesion Adolescent Adult Africa South of the Sahara - epidemiology AIDS Algorithms Analysis Antigens Biological effects Biology and Life Sciences Classification Cost engineering Diagnosis Diagnostic systems Diagnostic tests Diagnostic Tests, Routine Disease control Disease prevention Engineering and Technology Enzymes False Positive Reactions Female Guidelines Health aspects HIV HIV infections HIV Infections - diagnosis HIV Infections - epidemiology HIV Infections - psychology HIV tests Human immunodeficiency virus Human subjects Humans Infectious diseases Laboratories Laboratory tests Male Mass Screening - methods Medical diagnosis Medical research Medical tests Medicine and Health Sciences Military Military Personnel People and Places Physical Sciences Populations Practice Guidelines as Topic Prevalence Prevention programs Quality assurance Quality Assurance, Health Care - organization & administration Reporting Research and Analysis Methods Self Report Sensitivity and Specificity Social Sciences Studies Teenagers World Health Organization Sub-Saharan Africa United States > US Virginia California
ISSN:	1932-6203, 1932-6203
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Popis
Shrnutí:	HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey. The frequency of individuals who reported they were HIV-positive but subsequently tested HIV-negative using RDT algorithms ranged from 3.3 to 91.1%, suggesting significant rates of prior false-positive HIV RDT algorithm results, which should be confirmed using biological testing across time in future studies. Simple measures could substantially reduce false-positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World Health Organization's HIV testing guidelines. Other measures to improve RDT algorithm specificity include classifying individuals with weakly positive test lines as HIV indeterminate and retesting. While expansion of HIV testing in resource-limited countries is critical to identifying HIV-infected individuals for appropriate care and treatment, careful attention to potential causes of false HIV-positive results are needed to prevent the significant medical, psychological, and fiscal costs resulting from individuals receiving a false-positive HIV diagnosis.
Bibliografia:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: We have the following interests: Judith Harbertson, Bonnie R Tran, Anne G Thomas, Marni B Jacobs and Jennifer McAnany are employed by Leidos, Inc. There are no patents, products in development or marketed products to declare. This does not alter our adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0180796