Chang Joy, Tarasova Tetyana, Shanmugam Vedapuri, Azarskova Marianna, Nguyen Shon, Hurlston Mackenzie, Sabatier Jennifer, Zhang Guoqing, Osmanov Saladin, Ellenberger Dennis, Yang Chunfu, Vitek Charles, Liulchuk Maria, Nizova Natalya
Centers for Disease Control and Prevention, Atlanta, Georgia, USA
UNICEF, Kiev, Ukraine
J Clin Microbiol. 2015 Dec;53(12):3853-8. doi: 10.1128/JCM.02392-15. Epub 2015 Oct 7.
An accurate accessible test for early infant diagnosis (EID) is crucial for identifying HIV-infected infants and linking them to treatment. To improve EID services in Ukraine, dried blood spot (DBS) samples obtained from 237 HIV-exposed children (≤18 months of age) in six regions in Ukraine in 2012 to 2013 were tested with the AmpliSens DNA-HIV-FRT assay, the Roche COBAS AmpliPrep/COBAS TaqMan (CAP/CTM) HIV-1 Qual test, and the Abbott RealTime HIV-1 Qualitative assay. In comparison with the paired whole-blood results generated from AmpliSens testing at the oblast HIV reference laboratories in Ukraine, the sensitivity was 0.99 (95% confidence interval [CI], 0.95 to 1.00) for the AmpliSens and Roche CAP/CTM Qual assays and 0.96 (95% CI, 0.90 to 0.98) for the Abbott Qualitative assay. The specificity was 1.00 (95% CI, 0.97 to 1.00) for the AmpliSens and Abbott Qualitative assays and 0.99 (95% CI, 0.96 to 1.00) for the Roche CAP/CTM Qual assay. McNemar analysis indicated that the proportions of positive results for the tests were not significantly different (P > 0.05). Cohen's kappa (0.97 to 0.99) indicated almost perfect agreement among the three tests. These results indicated that the AmpliSens DBS and whole-blood tests performed equally well and were comparable to the two commercially available EID tests. More importantly, the performance characteristics of the AmpliSens DBS test meets the World Health Organization EID test requirements; implementing AmpliSens DBS testing might improve EID services in resource-limited settings.
准确且可及的早期婴儿诊断(EID)检测对于识别感染艾滋病毒的婴儿并使其获得治疗至关重要。为改善乌克兰的EID服务,对2012年至2013年从乌克兰六个地区的237名暴露于艾滋病毒的儿童(≤18个月龄)采集的干血斑(DBS)样本,采用AmpliSens DNA - HIV - FRT检测法、罗氏COBAS AmpliPrep/COBAS TaqMan(CAP/CTM)HIV - 1定性检测法和雅培实时HIV - 1定性检测法进行检测。与乌克兰各州艾滋病毒参考实验室进行的AmpliSens检测所产生的配对全血结果相比,AmpliSens和罗氏CAP/CTM定性检测法的灵敏度为0.99(95%置信区间[CI],0.95至1.00),雅培定性检测法的灵敏度为0.96(95%CI,0.90至0.98)。AmpliSens和雅培定性检测法的特异性为1.00(95%CI,0.97至1.00),罗氏CAP/CTM定性检测法的特异性为0.99(95%CI,0.96至1.00)。McNemar分析表明,各检测的阳性结果比例无显著差异(P>0.05)。Cohen's kappa值(0.97至0.99)表明三种检测之间几乎完全一致。这些结果表明,AmpliSens DBS检测和全血检测表现相当,且与两种市售EID检测相当。更重要的是,AmpliSens DBS检测的性能特征符合世界卫生组织EID检测要求;实施AmpliSens DBS检测可能会改善资源有限环境下的EID服务。