Africa Health Research Institute, KwaZulu-Natal, SA; Massachusetts General Hospital, Boston, USA; Harvard Medical School, Boston, USA; University of Kwazulu-Natal, Durban, SA.
Africa Health Research Institute, KwaZulu-Natal, SA; London School of Tropical Medicine and Hygiene, London, UK.
Diagn Microbiol Infect Dis. 2020 Jun;97(2):115031. doi: 10.1016/j.diagmicrobio.2020.115031. Epub 2020 Mar 2.
Rapid diagnostic tests (RDTs) are the mainstay of HIV diagnosis in the developing world but might have poor sensitivity among individuals taking antiretroviral therapy (ART). We leveraged a home-based HIV testing program linked to clinical data to compare the sensitivity of RDTs between individuals using versus not using ART. Field workers tested 6802 individuals using 2 HIV RDTs, which were compared to a single HIV immunoassay tested on dried blood spots. Approximately 5% (371/6802) tested positive by immunoassay, of whom 157 (42%) were currently on ART. The sensitivity of the Abon RDT among those never versus currently on ART was 91.6% (95% CI 88.3-94.3) and 96.6% (95% CI 88.3-94.3), respectively, and 95.4% (95% CI 92.8-97.3) versus 99.3% (95% CI 95.2-99.7) for the Advanced Quality assay. We report similar sensitivity of RDTs in ART-naïve and ART-experienced individuals, which mitigates concerns about their use among treated individuals in population-based epidemiologic surveys and those transferring care.
快速诊断检测（RDT）是发展中国家 HIV 诊断的主要手段，但在接受抗逆转录病毒治疗（ART）的个体中，其敏感性可能较差。我们利用与临床数据相关联的家庭为基础的 HIV 检测计划，比较了正在接受和未接受 ART 的个体中 RDT 的敏感性。现场工作人员使用 2 种 HIV RDT 检测了 6802 名个体，然后将其与在干血斑上进行的单次 HIV 免疫测定进行了比较。大约 5%（371/6802）通过免疫测定呈阳性，其中 157 人（42%）正在接受 ART。从未接受过与正在接受 ART 的个体中，Abon RDT 的敏感性分别为 91.6%（95%CI 88.3-94.3）和 96.6%（95%CI 88.3-94.3），而 Advanced Quality 检测的敏感性分别为 95.4%（95%CI 92.8-97.3）和 99.3%（95%CI 95.2-99.7）。我们报告了在 ART 初治和 ART 经验丰富的个体中 RDT 的相似敏感性，这减轻了对在基于人群的流行病学调查和那些正在转介接受护理的接受治疗的个体中使用 RDT 的担忧。
