Rapid HIV Tests During Labor

Assessment of a Rapid HIV Test Strategy During Labor [Nogueira SA et al. J Hum Virol 2001;4:278]: (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=
Retrieve&db=PubMed&list_uids=11907385&dopt=Abstract): The authors examined a method to rapidly detect HIV infection in women in labor in three public maternities in Rio de Janeiro. Each of 858 participants received three tests including two rapid tests (Determine-Abbott Labs, and Double Check-Orgenics, Yavne-- Israel) and standard serology. Of the 841 patients tested, 13 were positive by both rapid tests for a prevalence of 1.5%. There were seven discordant results, five were positive by the Determine test, and two results considered inconclusive by the Determine test. All of these were negative by the Double Check rapid test, and all were negative by the routine serologic test. The positive predictive value when two rapid tests were used was 13/13 (100%). For the Determine test alone, there were 5 of 18 false-positive tests for a positive predictive value of 72%. The authors conclude that two rapid tests allow more precise diagnosis and that this information is as valid as standard serology.

Comment: The tests used in this study provide results within 15 minutes, can detect HIV-2 as well as other viral variants, and are inexpensive [J Hum Virol 1997;1:45]. The study here was done with interpretation by trained laboratory technicians, but kits that are currently under review by the FDA may have the distinct advantage of being "provider read" if there is allowance for a waiver of CLIA regulations. In this report, perfect results were found with the Double Check test, but false-positives mandated a second test for the Determine assay. This difference may simply be a numbers game. The WHO recommends use of the two rapid tests in tandem.

Key words: serology, HIV

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