Misdiagnosis of HIV infection during a South African community-based survey: implications for rapid HIV testing

Tendesayi Kufa, Ayesha BM Kharsany, Cherie Cawood, David Khanyile, Lara Lewis, Anneke Grobler, Zawadi Chipeta, Alfred Bere, Mary Glenshaw, Adrian Puren

This study describes the overall accuracy and performance of a serial rapid HIV testing algorithm used in community-based HIV testing in the context of a population-based household survey conducted in two sub-districts of uMgungundlovu district, KwaZulu-Natal, South Africa, against reference fourth-generation HIV-1/2 antibody and p24 antigen combination immunoassays. We discuss implications of the findings on rapid HIV testing programmes.

The study found the overall accuracy of the rapid diagnostic tests (RDTs) algorithm high. However, there were a few false positives, and the sensitivity was lower than expected with high false negatives, despite implementation of quality assurance measures. False negatives were associated with recent (early) infection and ART exposure. The RDT algorithm was able to correctly identify the majority of HIV infections in community-based HIV testing. Messaging on the potential for false positives and false negatives should be included in these programmes.

August 31, 2017
Year of publication
2017
Resource types
Journal and research articles
Countries
Tags
quality assurance, testing accuracy, testing errors, HIV misdiagnosis, misdiagnosis, false positive, false negative, HIV testing algorithm, community-based HIV testing, South Africa, rapid HIV testing, rapid diagnostic tests (RDTs), ART exposure, treatment, early infection

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