Relative accuracy of serum, whole blood, and oral fluid HIV tests among Seattle men who have sex with men
Relative accuracy of serum, whole blood, and oral fluid HIV tests among Seattle men who have sex with men
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DOI：
10.1016/j.jcv.2013.09.018
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发表时间：
2013-12-01
影响因子：
8.8
通讯作者：
Branson, Bernard M.
中科院分区：
文献类型：
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作者：
Stekler, Joanne D.;O'Neal, Joshua D.;Branson, Bernard M.
背景：床旁（POC）快速HIV检测在“窗口期”的敏感性仅与最早一代EIA相当。迄今为止，还不清楚是否有任何POC测试执行显着优于others.Objective：POC测试，以检测早期感染的能力比较在真实的time.Study设计：男性与男性发生性关系（MSM）被招募到一个前瞻性的，横断面研究在两个艾滋病毒检测站点和一个研究诊所。程序比较了四种POC测试：一种是对口腔液体进行的，三种是对手指针刺全血标本进行的。来自POC结果为阴性的参与者的标本通过EIA和合并核酸扩增检测（NAAT）进行检测。结果：2010年2月至2013年5月期间，在2479次访问中，104名男性检测出艾滋病毒阳性。82名参与者有一致的反应性POC结果，3名参与者有一致的非反应性POC测试，但反应性EIA，8名参与者有急性感染。在1/2名POC结果不一致的参与者中，对口腔液进行的OraQuick ADVANCE快速HIV-1/2抗体检测识别的感染少于对手指针刺进行的OraQuick检测（p= 0.05），Uni-Gold Recombigen HIV检测（p= 0.01），并测定HIV-1/2 Ag/Ab组合（p= 0.05）。这些数据证实，口腔液POC检测比其他方法检测到的感染更少，并且最好保留在排除手指针刺或静脉穿刺的情况下。无论标本类型，POC测试未能确定许多艾滋病毒感染的男男性行为者在西雅图。在HIV高发病率的人群中，目前批准的POC抗体检测是不够的，除非补充p24抗原检测或NAAT。(C)2013爱思唯尔有限公司版权所有。
Background: Point-of-care (POC) rapid HIV tests have sensitivity during the "window period" comparable only to earliest generation EIAs. To date, it is unclear whether any POC test performs significantly better than others.Objective: Compare abilities of POC tests to detect early infection in real time.Study design: Men who have sex with men (MSM) were recruited into a prospective, cross-sectional study at two HIV testing sites and a research clinic. Procedures compared four POC tests: one performed on oral fluids and three on fingerstick whole blood specimens. Specimens from participants with negative POC results were tested by EIA and pooled nucleic acid amplification testing (NAAT). McNemar's exact tests compared numbers of HIV-infected participants detected.Results: Between February 2010 and May 2013, 104 men tested HIV-positive during 2479 visits. Eighty-two participants had concordant reactive POC results, 3 participants had concordant non-reactive POC tests but reactive EIAs, and 8 participants had acute infection. Of 12 participants with discordant POC results, OraQuick ADVANCE Rapid HIV-1/2 Antibody Test performed on oral fluids identified fewer infections than OraQuick performed on fingerstick (p=005), Uni-Gold Recombigen HIV test (p=.01), and determine HIV-1/2 Ag/Ab combo (p=005).Conclusions: These data confirm that oral fluid POC testing detects fewer infections than other methods and is best reserved for circumstances precluding fingerstick or venipuncture. Regardless of specimen type, POC tests failed to identify many HIV-infected MSM in Seattle. In populations with high HIV incidence, the currently approved POC antibody tests are inadequate unless supplemented with p24 antigen tests or NAAT. (C) 2013 Elsevier B.V. All rights reserved.