Screening and diagnostic testing protocols for HIV and Syphilis infections in health care setting in Qatar: Evaluation and recommendations

Gheyath K Nasrallah; Raniya Al-Buainain; Nadin Younes; Soha R Dargham; Duaa W Al-Sadeq; Mohamed Elhassan; Ibrahim Al-Shaar; Hadi M Yassine; Laith J Abu-Raddad; Mohamed M Emara; Ahmed Ismail

doi:10.1371/journal.pone.0278079

Screening and diagnostic testing protocols for HIV and Syphilis infections in health care setting in Qatar: Evaluation and recommendations

PLoS One. 2023 Feb 7;18(2):e0278079. doi: 10.1371/journal.pone.0278079. eCollection 2023.

Authors

Gheyath K Nasrallah^{1

2}, Raniya Al-Buainain³, Nadin Younes^{1

2}, Soha R Dargham^{4

5}, Duaa W Al-Sadeq^{2

6}, Mohamed Elhassan³, Ibrahim Al-Shaar³, Hadi M Yassine^{1

2}, Laith J Abu-Raddad^{4

5}, Mohamed M Emara⁶, Ahmed Ismail³

Affiliations

¹ Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
² Biomedical Research Center, Qatar University, Doha, Qatar.
³ Medical Commission Department, Laboratory Section, Ministry of Public Health, Doha, Qatar.
⁴ Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
⁵ World Health Organization Collaborating Centre for Disease Epidemiology Analytics on HIV/AIDS, Sexually Transmitted Infections, and Viral Hepatitis, Weill Cornell Medicine-Qatar, Cornell University, Doha, Qatar.
⁶ College of Medicine, QU Health, Qatar University, Doha, Qatar.

Abstract

Background: HIV and Syphilis are common STIs, which have become a concern and burden on healthcare systems, as many infections go untreated and lead to potentially serious complications. HIV is usually diagnosed with Western blot, PCR, and p24 antigen testing. Whereas, Syphilis is mainly diagnosed through clinical findings and serologic testing. The Medical Commission Department (MC) under MOPH is responsible for screening all newcomers to Qatar, aiming to keep the country free from serious infectious diseases.

Objective: We aimed to evaluate the diagnostic efficiency of the protocols used in the MC for screening HIV and Syphilis infections.

Methods: We conducted a retrospective study of samples analyzed by 4th Generation ARCHITECT® HIV Ag/Ab Combo and Rapid Plasma Reagin (RPR) between January to December 2019. ARCHITECT® HIV Ag/Ab Combo positive samples were confirmed by INNO-LIA™ HIVI/II and RT-PCR. RPR-reactive samples were confirmed by ARCHITECT® Syphilis Treponema pallidium Antibody (Syphilis TPA) assay.

Results: For HIV, data were collected from 585,587 individuals, of which 595 (0.1%) were positive by the ARCHITECT® HIV Ag/Ab Combo (Analyzer A). When all initially positive sera were re-tested on newly collected blood samples using different ARCHITECT® HIV Ag/Ab Combo analyzer (analyzer B), 99.8% (594/595) of samples were also positive, suggesting high reproducibility. The positive predictive value (PPV) between ARCHITECT® HIV Ag/Ab Combo and the INNO-LIA™ HIVI/II confirmatory assay was 31.8%. The PPV between ARCHITECT® HIV Ag/Ab Combo and HIV-PCR assay was 26.8%. Retrospective data for Syphilis were collected from a total of 97,298 individuals who visited the MC, of which 198 (0.20%) were initially positive by RPR. The PPV between RPR and Syphilis TPA confirmatory assay was 36.6%.

Conclusion: Despite the high rate of false positivity using ARCHITECT® HIV Ag/Ab Combo and RPR screening assays, both assays have proven to be highly effective as screening testing methods.

Copyright: © 2023 Nasrallah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

HIV Antibodies
HIV Infections* / diagnosis
HIV-1*
HIV-2
Humans
Immunoassay / methods
Mass Screening
Qatar
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Syphilis* / diagnosis
Treponema

Substances

HIV Antibodies

Grants and funding

SD and LJA are grateful for support provided by NPRP grant number 9-040-3-008 from the Qatar National Research Fund (a member of Qatar Foundation). GKN would like to acknowledge that the work was made possible by student grant number QUST-2-CHS-2022-501. N.Y is grateful for the support of GSRA8-L-1-0501-21022 from the Qatar National Research Fund (a member of Qatar Foundation). The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the article. The findings achieved herein are solely the responsibility of the authors.