HIV self-testing was more accurate with finger stick than oral fluid collection, according to findings of a prospective, multicenter study presented at the 2013 International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in Kuala Lumpur, Malaysia.
The study included 146 participants with HIV (male to female ratio of 1:3) and 60 HIV-uninfected control participants. Each participant took five sequential HIV rapid self-tests performed by health workers, four of which were saliva or gingival crevicular fluid-based, including OraQuick Advance Rapid HIV1/2 (OraSure), DPP HIV1/2 Assay (Chembio) and two additional A and B tests. Participants then took Sure Check HIV1/2 Assay (Chembio), a finger-stick whole blood test using 2.5 mcL whole blood.
HIV viral load and HIV antibodies–enzyme immunoassay optical density also were performed with routine tests. ART caused undetectable HIV viral load in 75% of the participants with HIV.
Of the oral fluid tests, OraQuick had 84.9% sensitivity, DPP 86.3%, test A 56.2% and test B 26.6% vs. 100% with the finger-stick whole blood test (P<.0001 for all). The sensitivity increased in patients with detectable HIV viral load to 94.6% in OraQuick, 97.3% in DPP, 89.2% in test A and 44.1% in test B. The specificity was 98.3% for OraQuick, DPP was 100%, test A was 100% and test B was 87.5%. The finger-stick whole blood test had 100% sensitivity in patients with detectable HIV viral load and 100% specificity.
“[Finger-stick whole blood] Sure Check was easy to use and highly reliable,” researchers wrote. “[Oral fluid] tests, despite ease of use, showed lower figures and need more data in untreated HIV-infected patients to be validated.”
For more information:
Jaspard M. Abstract MOLBPE33. Presented at: 7th IAS Conference on HIV Pathogenesis, Treatment and Prevention; June 30-July 03, 2013; Kuala Lumpur, Malaysia.