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Manjate A, Nilsson C, Axelsson M, Lindroth S, Sirbu D, Sacarlal J, Andersson S, Unemo M. Laboratory-based evaluation of the 4th-generation AlereTM HIV Combo rapid point-of-care test. PLoS One 2024; 19:e0298912. [PMID: 38394120 PMCID: PMC10889622 DOI: 10.1371/journal.pone.0298912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Mozambique is a high-prevalence country for HIV and early detection of new HIV infections is crucial for control of the epidemic. We aimed to evaluate the accuracy of the 4th-generation rapid diagnostic test (RDT) AlereTM HIV Combo in detecting acute and seroconverted HIV-infection, among sexually-active women attending three clinical health centers in Maputo, Mozambique. METHODS Women aged 14-55 years (n = 920) seeking care at the Mavalane Health Area, Maputo (February 2018-January 2019) were included, and blood specimens sampled. Sociodemographic and sexual behavior data were collected. Point-of-care HIV testing was performed using Alere DetermineTM HIV-1/2 and Uni-GoldTM HIV-1/2. All samples were also tested using Enzygnost® HIV Integral 4 and Innotest® HIV Antigen mAb in laboratory. The 4th-generation RDT AlereTM HIV Combo was evaluated on serum samples in the laboratory. Finally, Innotest® HIV Antigen mAb, Enzygnost® HIV Integral 4 (Ag/Ab), and HIV RNA quantification acted as gold standard assays in the evaluation of AlereTM HIV Combo test for HIV antigen detection (in clinical samples and in three HIV-1 seroconversion panels). RESULTS The antibody component of the 4th generation AlereTM HIV Combo RDT demonstrated a sensitivity and specificity of 100% examining clinical samples. However, the test did not detect HIV p24 antigen in any clinical samples, while Innotest® HIV Antigen mAb, verified by Enzygnost® HIV Integral 4 (Ag/Ab) and/or HIV RNA quantification, detected HIV antigen in six clinical samples. Furthermore, the AlereTM HIV Combo RDT had a low sensitivity in the detection of HIV p24 antigen in seroconversion panels. The HIV prevalence among the examined women was 17.8%. CONCLUSIONS The 4th-generation RDT AlereTM HIV Combo showed similar sensitivity to the 3rd-generation RDTs to detect seroconverted HIV-infections. However, the sensitivity for detection of HIV p24 antigen and diagnosing acute HIV infections, before seroconversion, was low. There is an urgent need to develop and evaluate simple and affordable POC tests with high sensitivity and specificity for diagnosing individuals with acute HIV infection in resource-limited settings with high HIV prevalence.
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Affiliation(s)
- Alice Manjate
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
- Faculdade de Medicina, Departamento de Microbiologia, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Charlotta Nilsson
- Public Health Agency of Sweden, Stockholm, Sweden
- Department of Laboratory Medicine, Division of Clinical Microbiology, Karolinska Institutet, Stockholm, Sweden
| | | | - Sarah Lindroth
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Desiree Sirbu
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Jahit Sacarlal
- Faculdade de Medicina, Departamento de Microbiologia, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Sören Andersson
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
- Public Health Agency of Sweden, Stockholm, Sweden
| | - Magnus Unemo
- Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
- Faculty of Medicine and Health, Department of Laboratory Medicine, WHO Collaborating Centre for Gonorrhoea and Other STIs, Microbiology, Örebro University, Örebro, Sweden
- Institute for Global Health, University College London (UCL), London, United Kingdom
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Kaperak C, Eller D, Devlin SA, Hall A, Schmitt J, Friedman EE, Beavis KG, Stanford KA, Pitrak D, McNulty MC. Reflex Human Immunodeficiency Virus (HIV) Type 1 RNA Testing Enables Timely Differentiation of False-Positive Results From Acute HIV Infection. Open Forum Infect Dis 2024; 11:ofad629. [PMID: 38269050 PMCID: PMC10807991 DOI: 10.1093/ofid/ofad629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 12/11/2023] [Indexed: 01/26/2024] Open
Abstract
Accurate, timely human immunodeficiency virus (HIV) diagnosis is critical. Routine HIV screening program data were examined before and after reflex HIV type 1 RNA testing. Reflex testing facilitated confirmation of reactive HIV screening assays (as true or false positives) (odds ratio, 23.7 [95% confidence interval, 6.7-83.4]; P < .0001), improving detection of acute HIV and reducing unconfirmed discordant results.
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Affiliation(s)
- Christopher Kaperak
- Department of Medicine, University of Chicago Medicine, Chicago, Illinois, USA
| | - Dylan Eller
- Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - Samantha A Devlin
- Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - André Hall
- Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - Jessica Schmitt
- Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - Eleanor E Friedman
- Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - Kathleen G Beavis
- Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - Kimberly A Stanford
- Section of Emergency Medicine, University of Chicago, Chicago, Illinois, USA
| | - David Pitrak
- Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
| | - Moira C McNulty
- Section of Infectious Diseases and Global Health, University of Chicago, Chicago, Illinois, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, Illinois, USA
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Aguilar R, Cruz A, Jiménez A, Almuedo A, Saumell CR, Lopez MG, Gasch O, Falcó G, Jiménez-Lozano A, Martínez-Perez A, Sanchez-Collado C, Tedesco A, López MC, Pinazo MJ, Leonel T, Bisoffi Z, Färnert A, Dobaño C, Requena-Méndez A. Evaluation of the accuracy of a multi-infection screening test based on a multiplex immunoassay targeting imported diseases common in migrant populations. Travel Med Infect Dis 2024; 57:102681. [PMID: 38141899 DOI: 10.1016/j.tmaid.2023.102681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/08/2023] [Accepted: 12/15/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND We aimed to evaluate the performance of a novel multiplex serological assay, able to simultaneously detect IgG of six infections, as a screening tool for imported diseases in migrants. METHODS Six panels of 40 (n = 240) anonymized serum samples with confirmed infections were used as positive controls to assess the multiplex assay's sensitivity. One panel of 40 sera from non-infected subjects was used to estimate the seropositivity cutoffs, and 32 non-infected sera were used as negative controls to estimate each serology's sensitivity and specificity. The multi-infection screening test was validated in a prospective cohort of 48 migrants from endemic areas. The sensitivity of the Luminex assay was calculated as the proportion of positive results over all positive samples identified by reference tests. The specificity was calculated using 32 negative samples. Uncertainty was quantified with 95 % confidence intervals using receiver operating characteristic analyses. RESULTS The sensitivity/specificity were 100 %/100 % for HIV (gp41 antigen), 97.5 %/100 % for Hepatitis B virus (HBV-core antigen), 100 %/100 % for Hepatitis C virus (HCV-core antigen), 92.5 %/90.6 % for strongyloidiasis [31-kDa recombinant antigen (NIE)], 97.5 %/100 % for schistosomiasis (combined serpin Schistosoma mansoni and S.haematobium antigens) and 95 %/90.6 % for Chagas disease [combined Trypanosoma cruzi kinetoplastid membrane protein-11 (KMP11) and paraflagellar rod proteins 2 (PFR2) antigens]. In the migrant cohort, antibody response to the combination of the T.cruzi antigens correctly identified 100 % individuals, whereas HBV-core antigen correctly identified 91.7 % and Strongyloides-NIE antigen 86.4 %. CONCLUSIONS We developed a new, robust and accurate 8-plex Luminex assay that could facilitate the implementation of screening programmes targeting migrant populations.
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Affiliation(s)
- Ruth Aguilar
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Carrer Roselló 132, 08036, Barcelona, Spain
| | - Angeline Cruz
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Carrer Roselló 132, 08036, Barcelona, Spain
| | - Alfons Jiménez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Carrer Roselló 132, 08036, Barcelona, Spain; Biomedical Research Networking Center for Epidemiology and Public Health (CIBERESP), Avenida Monforte de Lemos 3-5, 28029, Madrid, Spain
| | - Alex Almuedo
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Carrer Roselló 132, 08036, Barcelona, Spain
| | - Carme Roca Saumell
- Centre d'Atenció Primaria El Clot, Institut Català de la Salut (ICS), Carrer Concilio de Trento 25, 08018, Barcelona, Spain; Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), Carrer Casanova, 143, 08036, Barcelona, Spain
| | - Marina Gigante Lopez
- Centre d'Atenció Primaria Center Numància, Institut Català de la Salut (ICS), Carrer Numància 23, 08029, Barcelona, Spain
| | - Oriol Gasch
- Infectious Diseases Department, Hospital Universitari Parc Taulí. Institut d'Investigació i Innovació Parc Taulí. Universitat Autònoma de Barcelona, Parc Taulí, 1, 08208, Sabadell-Barcelona, Spain
| | - Gemma Falcó
- Centre d'Atenció Primaria Sant Miquel, Institut Català de la Salut (ICS), Carrer Francesc Macià i Llussà, 154, 08401, Granollers-Barcelona, Spain
| | - Ana Jiménez-Lozano
- Centre d'Atenció Primaria Adrià 5A Marc Aureli, Institut Català de la Salut (ICS), Carrer Vallmajor, 34, 08021, Barcelona, Spain
| | - Angela Martínez-Perez
- Centre d'Atenció Primaria Casanova. Consorci d'Atenció Primària de Salut de l'Eixample (CAPSBE) Casanova. Carrer Rosselló 161, 08036, Barcelona, Spain
| | - Consol Sanchez-Collado
- Centre d'Atenció Primaria Torelló, Institut Català de la Salut (ICS), Avenida Pompeu Fabra, 8, 08570, Torelló-Barcelona, Spain
| | - Andrea Tedesco
- Department of Infectious Tropical diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar di Valpolicella, Italy
| | - Manuel Carlos López
- Spanish National Research Council (IPBLN-CSIC), Avenida del Conocimiento 17, Parque Tecnológico de Ciencias de la Salud, 18016, Granada, Spain
| | - María Jesús Pinazo
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Carrer Roselló 132, 08036, Barcelona, Spain; Biomedical Research Networking Center (CIBER) of Infectious Diseases, Carlos III Health Institute (CIBERINFEC, ISCIII), Carrer Melchor Fernández Almagro, 3, 28029, Madrid, Spain; Drugs for Neglected Diseases Iniciative (DNDi), Switzerland
| | - Thais Leonel
- Liver Unit, Hospital Clínic, University of Barcelona, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Biomedical Research Networking Center of Hepatic and Digestive Diseases (CIBEREHD), Carrer Villarroel, 170, 08036, Barcelona, Spain
| | - Zeno Bisoffi
- Department of Infectious Tropical diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Sempreboni 5, 37024, Negrar di Valpolicella, Italy
| | - Anna Färnert
- Department of Medicine Solna, Karolinska Institutet, Solnavägen 1, 17177, Solna-Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Solnavägen 1, 17177, Solna-Stockholm, Sweden
| | - Carlota Dobaño
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Carrer Roselló 132, 08036, Barcelona, Spain; Biomedical Research Networking Center (CIBER) of Infectious Diseases, Carlos III Health Institute (CIBERINFEC, ISCIII), Carrer Melchor Fernández Almagro, 3, 28029, Madrid, Spain
| | - Ana Requena-Méndez
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Carrer Roselló 132, 08036, Barcelona, Spain; Biomedical Research Networking Center (CIBER) of Infectious Diseases, Carlos III Health Institute (CIBERINFEC, ISCIII), Carrer Melchor Fernández Almagro, 3, 28029, Madrid, Spain; Department of Medicine Solna, Karolinska Institutet, Solnavägen 1, 17177, Solna-Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Solnavägen 1, 17177, Solna-Stockholm, Sweden.
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