Screening for acute HIV infection in South Africa: finding acute and chronic disease.

Show simple item record Bassett, I en Chetty, S en Giddy, J en Reddy, S en Bishop, Karen en Lu, Z en Losina, E en Freedberg, K en Walensky, R en 2012-03-01T01:57:37Z en 2011 en
dc.identifier.citation HIV Medicine 12(1):46-53 2011 en
dc.identifier.issn 1464-2662 en
dc.identifier.uri en
dc.description.abstract Background The yield of screening for acute HIV infection among general medical patients in resource-scarce settings remains unclear. Our objective was to evaluate the strategy of using pooled HIV plasma RNA to diagnose acute HIV infection in patients with negative or discordant rapid HIV antibody tests in Durban, South Africa. Methods We prospectively enrolled patients with negative or discordant rapid HIV antibody tests from a routine HIV screening programme in an out-patient department in Durban with an HIV prevalence of 48%. Study participants underwent venipuncture for pooled qualitative HIV RNA, and, if this was positive, quantitative RNA, enzyme immunoassay and Western blot (WB). Patients with negative or indeterminate WB and positive quantitative HIV RNA were considered acutely infected. Those with chronic infection (positive RNA and WB) despite negative or discordant rapid HIV tests were considered to have had false negative rapid antibody tests. Results Nine hundred and ninety-four participants were enrolled with either negative (n5976) or discordant (n518) rapid test results. Eleven [1.1%; 95% confidence interval (CI) 0.6–2.0%] had acute HIV infection, and an additional 20 (2.0%; 95% CI 1.3–3.1%) had chronic HIV infection (false negative rapid test). Conclusions One per cent of out-patients with negative or discordant rapid HIV tests in Durban, South Africa had acute HIV infection readily detectable through pooled serum HIV RNA screening. Pooled RNA testing also identified an additional 2% of patients with chronic HIV infection. HIV RNA screening has the potential to identify both acute and chronic HIV infections that are otherwise missed by standard HIV testing algorithms. Keywords: acute HIV, Africa, HIV screening, en
dc.publisher Blackwell Publishing Ltd. en
dc.relation.ispartofseries HIV Medicine en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from en
dc.rights.uri en
dc.title Screening for acute HIV infection in South Africa: finding acute and chronic disease. en
dc.type Journal Article en
dc.identifier.doi 10.1111/j.1468-1293.2010.00850.x. en
pubs.issue 1 en
pubs.begin-page 46 en
pubs.volume 12 en
dc.rights.holder Copyright: Blackwell Publishing Ltd. en
dc.identifier.pmid 20553336 en
pubs.end-page 53 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Article en
pubs.elements-id 196140 en Medical and Health Sciences en Medical Sciences en Auckland Cancer Research en
pubs.record-created-at-source-date 2010-12-13 en
pubs.dimensions-id 20553336 en

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