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Re-reading of OraQuick HIV-1/2 rapid antibody test results: quality assurance implications for HIV self-testing programmes.

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Watson, Victoria, Dacombe, Russell ORCID: https://orcid.org/0000-0002-6705-1537, Williams, Christopher, Edwards, Thomas, Adams, Emily ORCID: https://orcid.org/0000-0002-0816-2835, Johnson, Cheryl C, Mutseta, Miriam N, Corbett, Elizabeth L, Cowan, Frances ORCID: https://orcid.org/0000-0003-3087-4422, Ayles, Helen, Hatzold, Karin, MacPherson, Peter ORCID: https://orcid.org/0000-0002-0329-9613 and Taegtmeyer, Miriam ORCID: https://orcid.org/0000-0002-5377-2536 (2019) 'Re-reading of OraQuick HIV-1/2 rapid antibody test results: quality assurance implications for HIV self-testing programmes.'. Journal of the International AIDS Society, Vol 22 Suppl 1, e25234.

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Abstract

INTRODUCTION

Scale-up of HIV self-testing (HIVST) will play a key role in meeting the United Nation's 90-90-90 targets. Delayed re-reading of used HIVST devices has been used by early implementation studies to validate the performance of self-test kits and to estimate HIV positivity among self-testers. We investigated the stability of results on used devices under controlled conditions to assess its potential as a quality assurance approach for HIVST scale-up.

METHODS

444 OraQuick HIV-1/2 rapid antibody tests were conducted using commercial plasma from two HIV-positive donors and HIV-negative plasma (high-reactive n = 148, weak-reactive n = 148 and non-reactive n = 148) and incubated them for six months under four conditions (combinations of high and low temperatures and humidity). Devices were re-read daily for one week, weekly for one subsequent month and then once a month by independent readers unaware of the previous results. We used multistage transition models to investigate rates of change in device results, and between storage conditions.

RESULTS AND DISCUSSION

There was a high incidence of device instability. Forty-three (29%) of 148 initially non-reactive results became false weak-reactive results. These changes were observed across all incubation conditions, the earliest on Day 4 (n = 9 kits). No initially HIV-reactive results changed to a non-reactive result. There were no significant associations between storage conditions and hazard of results transition. We observed substantial statistical agreement between independent re-readers over time (agreement range: 0.74 to 0.96).

CONCLUSIONS

Delayed re-reading of used OraQuick HIV-1/2 rapid antibody tests is not currently a valid methodological approach to quality assurance and monitoring as we observed a high incidence (29%) of true non-reactive tests changing to false weak-reactive and therefore its use may overestimate true HIV positivity.

Item Type: Article
Subjects: QW Microbiology and Immunology > Antigens and Antibodies. Toxins and Antitoxins > QW 575 Antibodies
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.1 Diagnosis
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI): https://doi.org/10.1002/jia2.25234
Depositing User: Stacy Murtagh
Date Deposited: 26 Mar 2019 17:14
Last Modified: 26 Mar 2019 17:14
URI: http://archive.lstmed.ac.uk/id/eprint/10492

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