Olaru Ioana D, McHugh Grace, Dakshina Suba, Majonga Edith, Dauya Ethel, Bandason Tsitsi, Kranzer Katharina, Mujuru Hilda, Ferrand Rashida A
Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany.
Biomedical Research and Training Institute, Harare, Zimbabwe.
J Int AIDS Soc. 2017 Aug 29;20(Suppl 6):21751. doi: 10.7448/IAS.20.7.21751.
Rapid diagnostic tests (RDT) for HIV infection have high sensitivity and specificity, but in the setting of longstanding antiretroviral therapy (ART), can give false results that can lead to misinterpretation, confusion and inadequate management. The objective of this study was to evaluate the proportion of falsely negative results of a RDT performed on oral fluid in HIV-infected children on longstanding ART.
One hundred and twenty-nine children with known HIV infection and receiving ART were recruited from the HIV Clinic at the Harare Central Hospital, Zimbabwe. HIV testing was performed on oral fluid and on finger-stick blood.
Children included in the study had a median age of 12 years (IQR 10-14) and 67 (51.9%) were female. Median age at HIV diagnosis was 5 years (IQR 3-6) and the median time on ART was 6.3 years (IQR 4.3-8.1). The oral fluid test was negative in 11 (8.5%) patients and indeterminate in 2 (1.6%). Finger-stick blood test was negative in 1 patient. Patients with a negative oral fluid test had a higher CD4 cell count (967 vs. 723 cells/mm, = 0.016) and a longer time on ART (8.5 vs. 6 years, = 0.016).
This study found that a substantial proportion of false-negative HIV test results in children on longstanding ART when using an oral fluid test. This could lead to misinterpretation of HIV test results and in the false perception of cure or delayed diagnosis.
用于检测HIV感染的快速诊断检测（RDT）具有较高的灵敏度和特异性，但在长期抗逆转录病毒治疗（ART）的情况下，可能会给出导致误解、混淆和管理不当的错误结果。本研究的目的是评估对长期接受ART治疗的HIV感染儿童进行口腔液RDT检测时假阴性结果的比例。
从津巴布韦哈拉雷中心医院的HIV诊所招募了129名已知感染HIV并接受ART治疗的儿童。对口腔液和指尖血进行HIV检测。
纳入研究的儿童中位年龄为12岁（四分位间距10 - 14岁），67名（51.9%）为女性。HIV诊断时的中位年龄为5岁（四分位间距3 - 6岁），ART治疗的中位时间为6.3年（四分位间距4.3 - 8.1年）。11名（8.5%）患者的口腔液检测结果为阴性，2名（1.6%）为不确定。指尖血检测有1名患者结果为阴性。口腔液检测结果为阴性的患者CD4细胞计数较高（967对723个细胞/mm，P = 0.016），ART治疗时间较长（8.5对6年，P = 0.016）。
本研究发现，在长期接受ART治疗的儿童中，使用口腔液检测时HIV检测出现大量假阴性结果。这可能导致对HIV检测结果的误解以及对治愈的错误认知或诊断延迟。
