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|Title: ||Limitations of Rapid HIV-1 tests during screening for trials in Uganda: diagnostic test accuracy study|
|Authors: ||Serwadda, David|
Gray, Ronald H.
Reynolds, Steven J.
Sewankambo, Nelson K.
Wawer, Maria J.
|Issue Date: ||2007 |
|Publisher: ||BMJ Publishing Group|
|Citation: ||Serwadda, D., Makumbi, F., Gray, R.H., Lutalo, T., Nalugoda, F., Opendi, P., Kigozi, G., Reynolds, S.J., Sewankambo, N.K., Wawer, M.J. (2007). Limitations of Rapid HIV-1 tests during screening for trials in Uganda: diagnostic test accuracy study. BMJ, 335(7612)|
|Abstract: ||Objective To evaluate the limitations of rapid tests for HIV-1.
Design Diagnostic test accuracy study.
Setting Rural Rakai, Uganda.
Participants 1517 males aged 15-49 screened for trials of
circumcision for HIV prevention.
Main outcome measures Sensitivity, specificity, negative
predictive values, and positive predictive values of an
algorithm using three rapid tests for HIV, compared with
the results of enzyme immunoassay and western blotting
as the optimal methods.
Results Rapid test results were evaluated by enzyme
immunoassay and western blotting. Sensitivity was
97.7%. Among 639 samples where the strength of
positive bands was coded if the sample showed positivity
for HIV, the algorithm had low specificity (94.1%) and a
low positive predictive value (74.0%). Exclusion of 37
samples (5.8%) with a weak positive band improved the
specificity (99.6%) and positive predictive value (97.7%).
Conclusion Weak positive bands on rapid tests for HIV
should be confirmed by enzyme immunoassay and
western blotting before disclosing the diagnosis.
Programmes using rapid tests routinely should use
standard serological assays for quality control.|
|URI: ||doi: 10.1136/bmj.39210.582801.BE|
|Appears in Collections:||Research Articles (Public-Health)|
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