Diagnosing acute HIV infection at point of care: a retrospective analysis of the sensitivity and specificity of a fourth-generation point-of-care test for detection of HIV core protein p24.

Friday, 17 February, 2017
  • Fitzgerald N,
  • Cross M,
  • O'Shea S,
  • Fox J

Abstract

OBJECTIVES:

Detection of acute HIV infection is vital in preventing onward transmission. HIV point-of-care testing (POCT) has improved uptake of HIV testing but has been limited to third-generation assays, which only detect chronic HIV infection. Previous evaluation of thefourth-generation Alere Determine HIV-1/2 Ag/Ab Combo POCT showed only 50% sensitivity for HIV core protein p24 (p24 antigen)detection, which is suboptimal for diagnosis of acute HIV infection with limited advantage over third-generation POCT. We aimed to assess the sensitivity of the new Alere HIV Combo POCT to detect acute HIV infection.

METHODS:

Stored samples in samples already identified as p24-positive using standard-of-care fourth-generation assays were randomly selected alongside groups of antibody-positive samples and HIV-negative samples. Each sample was tested using the new Alere POCT according to manufacturer's instructions. Sensitivity and specificity were then calculated.

RESULTS:

The Alere HIV Combo POCT test demonstrated 88% sensitivity 95% CI (78% to 98%) and 100% specificity 95% CI (99.7% to 100%) for detection of p24 antigen.

CONCLUSIONS:

This new POCT shows improved sensitivity for detection of p24 antigen and may be of value for clinical use in detectingacute HIV infection. Further evaluation of its use in a clinical setting is still required.

Where Can I Read This Full Article?

The full article is available to read here 

Sex Transm Infect. 2017 Mar;93(2):100-101. doi: 10.1136/sextrans-2015-052491. Epub 2016 Jun 7.

PMID: 27272704