Feasibility of performing multiple point of care testing for HIV anti-retroviral treatment initiation and monitoring from multiple or single fingersticks.
Feasibility of performing multiple point of care testing for HIV anti-retroviral treatment initiation and monitoring from multiple or single fingersticks.
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DOI：
10.1371/journal.pone.0085265
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Stevens W
中科院分区：
文献类型：
--
作者：
Gous N;Scott L;Potgieter J;Ntabeni L;Enslin S;Newman R;Stevens W
护理点检测（POCT）提供现场，快速，可访问的结果。根据目前南非的抗逆转录病毒治疗指南，如果使用POC，可能需要多达4次手指针刺/患者/诊所访视。我们确定了护士在多次手指针刺上进行多次POCT的可行性和准确性，然后通过在单次手指针刺上进行多次POC来简化该过程。在南非的HIV治疗诊所就诊的随机HIV阳性成人患者，接受ART启动/监测，在2012年4月至6月期间参与研究。I期：n = 150例患者因多次手指针刺接受多次POCT。II期：n = 150例患者在单次手指针刺中接受多次POCT。以下POC检测由专职护士进行：PIMA（CD4）、HemoCue（血红蛋白）、Reflotron（丙氨酸氨基转移酶、肌酐）。采集静脉穿刺样本用于同品种实验室方法。正常实验室范围和澳大利亚皇家病理学家学院（RCPA）允许的差异用作比较指南。在67%的受试者中，每次访视要求进行≥ 3次检测。所有POCT均准确，但存在变异性。第一阶段：血红蛋白是准确的（3.2%CV），而CD4、丙氨酸氨基转移酶和肌酐的变异性增加（分别为16.3%CV; 9.3%CV; 12.9%CV）。PIMA产生了12.4%的错误分类。第二阶段：血红蛋白、丙氨酸氨基转移酶和肌酐显示出良好的准确性（分别为3.2%CV、8.7%CV、6.4%CV），CD4变异性增加（12.4%CV），但临床错误分类率低（4.1%）。在单次手指针刺进行POC的序列中未观察到趋势。总体而言，PIMA CD4产生的错误率最高（16 - 19%）。用于ART启动和/或监测的多个POCT实际上可以由专门的护士在多个手指针刺上进行。该过程与等同方法学一样准确，并且可以使用单次手指针刺进行简化。
Point of Care testing (POCT) provides on-site, rapid, accessible results. With current South African anti-retroviral treatment guidelines, up to 4 fingersticks /patient/clinic visit could be required if utilizing POC. We determined the feasibility and accuracy of a nurse performing multiple POCT on multiple fingersticks followed by simplification of the process by performance of multiple POC on a single fingerstick. Random HIV positive adult patients presenting at a HIV treatment clinic in South Africa, for ART initiation/ monitoring, were approached to participate in the study between April-June 2012. Phase I: n=150 patients approached for multiple POCT on multiple fingersticks. Phase II: n=150 patients approached for multiple POCT on a single fingerstick. The following POC tests were performed by a dedicated nurse: PIMA (CD4), HemoCue (hemoglobin), Reflotron (alanine aminotransferase, creatinine). A venepuncture specimen was taken for predicate laboratory methodology. Normal laboratory ranges and Royal College of Pathologists Australasia (RCPA) allowable differences were used as guidelines for comparison. In 67% of participants, ≥3 tests were requested per visit. All POCT were accurate but ranged in variability. Phase I: Hemoglobin was accurate (3.2%CV) while CD4, alanine aminotransferase and creatinine showed increased variability (16.3%CV; 9.3%CV; 12.9%CV respectively). PIMA generated a misclassification of 12.4%. Phase II: Hemoglobin, alanine aminotransferase and creatinine showed good accuracy (3.2%CV, 8.7%CV, 6.4%CV respectively) with increased variability on CD4 (12.4%CV) but low clinical misclassification (4.1%). No trends were observed for the sequence in which POC was performed on a single fingerstick. Overall, PIMA CD4 generated the highest error rate (16-19%). Multiple POCT for ART initiation and/or monitoring can be performed practically by a dedicated nurse on multiple fingersticks. The process is as accurate as predicate methodology and can be simplified using a single fingerstick.
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影响因子：
3.7
作者：
Losina E;Bassett IV;Giddy J;Chetty S;Regan S;Walensky RP;Ross D;Scott CA;Uhler LM;Katz JN;Holst H;Freedberg KA
通讯作者：
Freedberg KA
影响因子：
3.7
作者：
Manabe, Yukari C.;Wang, Yaping;Castelnuovo, Barbara
通讯作者：
Castelnuovo, Barbara
影响因子：
3.4
作者：
Denny, Thomas N.;Gelman, Rebecca;Glencross, Deborah K.
通讯作者：
Glencross, Deborah K.
影响因子：
2.1
作者：
Gehring, H;Hornberger, C;Schmucker, P
通讯作者：
Schmucker, P
DOI：
10.1097/qai.0b013e31825eec60
发表时间：
2012-10-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Larson BA;Schnippel K;Ndibongo B;Xulu T;Brennan A;Long L;Fox MP;Rosen S
通讯作者：
Rosen S