Performance of HIV Rapid Tests Among Breastfeeding, Malawian Infants.
Performance of HIV Rapid Tests Among Breastfeeding, Malawian Infants.
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马拉维婴儿母乳喂养中艾滋病毒快速检测的表现。
DOI：
10.1097/inf.0000000000001384
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
VanRie,Annelies
中科院分区：
文献类型：
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作者：
Smith,EmilyR;Sheahan,AnnaD;Heyderman,RobertS;Miller,WilliamC;Wheeler,Stephanie;Hudgens,Michael;Nelson,JulieAE;Dube,Queen;VanRie,Annelies
Materials and Methods:We collected data on the performance of 2 commonly used rapid tests (Determine and Unigold) in Malawi between 2008 and 2012 or at the University of North Carolina between 2014 and 2015. For each 3-month interval between ages 3 and 18 months, we calculated the sensitivity, specificity, positive and negative predictive values of each test compared with the HIV DNA/RNA PCR gold standard. We also assessed the utility of each rapid test to diagnose incident HIV infection during the breastfeeding period.Results:Among 121 HIV-exposed infants who were negative at age 6 weeks, 21 (17.2%) became infected by 18 months. At 3 months of age, both rapid tests had minimal clinical value with specificity values of 7.0%[95% confidence interval (CI): 2.3–15.7] for Determine and 19.4%(95% CI: 11.1–30.5) for Unigold. Starting at age 6 and 9 months, the Unigold test could be used as a screening tool in the follow-up of HIV-exposed infants with specificity values of 83.7%(95% CI: 74.4–89.9) and 97.7%(95% CI: 94.6–99.7), respectively. Starting at age 12 months, the type of test became less important as both tests performed well in identifying HIV-free children, although both tests failed to detect some incident HIV infections.Conclusions:Updated guidelines for the use of rapid tests in young HIV-exposed children that explicitly take type of test and infant age into account are urgently needed to ensure optimal care for the 1.5 million HIV-exposed infants born annually.
