Assessment of HIV Screening Tests for Use in Preexposure Prophylaxis Programs

J Infect Dis. 2017 Aug 1;216(3):382-386. doi: 10.1093/infdis/jix297.

Abstract

Preexposure prophylaxis programs involve frequent human immunodeficiency virus (HIV) testing. We evaluated the sensitivity of 2 antigen/antibody immunoassays (Architect and Bioplex), 2 antibody-based rapid tests (Vikia-HIV-1/2 and Autotest-VIH), and 1 antigen/antibody rapid test (Alere HIV Combo) for the diagnosis of HIV infection. Among the 31 HIV-1-infected participants in the ANRS-IPERGAY trial, HIV-1 RNA was detected alone in only 2. The sensitivities of the Architect and Bioplex assays were 83% (95% confidence interval [CI], 76%-99%) and 82% (95% CI, 63%-94%), respectively. The sensitivities of the Vikia, Autotest, and Alere tests were 54% (95% CI, 34%-72%), 50% (95% CI, 31%-69%), and 78% (95% CI, 58%-91%), respectively. Antigen/antibody tests should be preferred to avoid missing cases of acute HIV infection and to decrease the related risks of viral transmission and emergence of drug resistance.

Keywords: HIV diagnosis; HIV-1; HIV-1 RNA; PrEP; acute infection; antigen/antibody test; rapid test; recent infection.

Publication types

  • Evaluation Study

MeSH terms

  • HIV Antibodies / blood
  • HIV Antigens / blood
  • HIV Infections / diagnosis*
  • HIV Infections / prevention & control*
  • HIV-1
  • Humans
  • Immunoassay / methods*
  • Mass Screening / methods
  • Pre-Exposure Prophylaxis*
  • RNA, Viral / blood
  • Retrospective Studies
  • Sensitivity and Specificity
  • Serologic Tests

Substances

  • HIV Antibodies
  • HIV Antigens
  • RNA, Viral