Bonnet J, Ducroix-Roubertou S, Rogez S, Ajzenberg D, Courtioux B, Faucher J-F
Université de Limoges, U1094, Neuroépidémiologie tropicale, Institut d'épidémiologie et de neurologie tropicale, GEIST, Limoges, France.
Service des maladies infectieuses et tropicales, Centre hospitalier universitaire de Limoges, Limoges, France.
Med Trop Sante Int. 2021 Jun 20;1(2). doi: 10.48327/mtsibulletin.2021.115. eCollection 2021 Jun 30.
Approaching the mechanisms related to false positives HIV rapid diagnostic tests (RDT) in patients with sleeping sickness may help to improve the accuracy of screening for HIV infection in areas endemic for Human African trypanosomiasis (HAT).We report on a patient from Congo who was managed like an AIDS-associated meningoencephalitis, based on a false positive HIV RDT at admission, and eventually received a diagnosis of sleeping sickness. A further retrospective cohort study performed in patients with HAT shows that most of positive HIV RDT obtained prior to treatment for sleeping sickness are false positives. We found that half of them were cleared at the end of treatment course, suggesting an early clearance of some antibodies involved in cross-reactivity.A substantial clearance of HIV RDT false positives occurs during therapy for HAT. In areas where Elisa HIV tests are not readily available, repeating the HIV RDT at the end of therapy may help to identify roughly half of false positives.
探究昏睡病患者中HIV快速诊断检测(RDT)出现假阳性的相关机制,可能有助于提高在非洲人类锥虫病(HAT)流行地区进行HIV感染筛查的准确性。我们报告了一名来自刚果的患者,该患者入院时基于HIV RDT假阳性被当作艾滋病相关脑膜脑炎进行治疗,最终被诊断为昏睡病。在HAT患者中进行的另一项回顾性队列研究表明,大多数在治疗昏睡病之前获得的HIV RDT阳性结果为假阳性。我们发现其中一半在治疗疗程结束时转阴,这表明一些参与交叉反应的抗体得以早期清除。在HAT治疗期间,HIV RDT假阳性结果会大量清除。在无法轻易获得HIV酶联免疫吸附测定(ELISA)检测的地区,在治疗结束时重复进行HIV RDT检测可能有助于识别大约一半的假阳性结果。