Open AccessUse of Point-of-Care Nucleic Acid Tests Beyond Early Infant Diagnosis of HIV: A Retrospective Case Review in Lesotho
Author(s) -
Kenneth Macneal,
Vincent Tukei,
Emma Sacks,
Majoalane Mokone,
Lehlohonolo Makoti,
Esther Tumbare,
Tebello Samosamo,
Tsietso Mots’oane,
Jean-François Lemaire,
Jennifer Cohn
Publication year - 2020
Publication title -
journal of acquired immune deficiency syndromes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.162
H-Index - 157
eISSN - 1944-7884
pISSN - 1525-4135
DOI - 10.1097/qai.0000000000002381
Subject(s) - interquartile range , medicine , point of care testing , nucleic acid test , point of care , retrospective cohort study , diagnostic test , nucleic acid , human immunodeficiency virus (hiv) , antiretroviral therapy , nat , polymerase chain reaction , pediatrics , viral load , immunology , disease , pathology , biology , infectious disease (medical specialty) , statistics , biochemistry , mathematics , covid-19 , gene
Rapid diagnostic tests (RDTs) for HIV antibodies remain the primary method of diagnosis of HIV in individuals over age 18 months in Lesotho. Although antibody tests have high sensitivity and specificity, up to 2.3% of serial two-test algorithms can have discrepant results between RDTs. In the case of inconclusive RDT results, Lesotho guidelines at the time of this study recommended either repeat testing with the same RDT algorithm after 14 days or immediately collect a blood sample to be sent for laboratory-based polymerase chain reaction testing. Point-of-care qualitative nucleic acid tests (POC qual NAT) may have benefits in rapidly resolving these inconclusive results, particularly when compared with repeating RDTs later or conventional polymerase chain reaction testing at the National Reference Laboratory.