Hubert Demorat1, Amanda Lopes2, Dorothée Chopin2, Véronique Delcey1, Philippe Clevenbergh1, Guy Simoneau2, John Evans1, Stéphane Mouly2, Jean-François Bergmann3, Pierre Sellier4. 1. Assistance publique-hôpitaux de Paris, Saint-Louis/Lariboisière-Fernand-Widal Hospital, Department of Internal Medicine, Unit of Infectious Diseases, 2, rue Ambroise Paré, 75475 Paris cedex 10, France. 2. Assistance publique-hôpitaux de Paris, Saint-Louis/Lariboisière-Fernand-Widal Hospital, Department of Internal Medicine, 75475 Paris cedex 10, France. 3. Assistance publique-hôpitaux de Paris, Saint-Louis/Lariboisière-Fernand-Widal Hospital, Department of Internal Medicine, 75475 Paris cedex 10, France. Electronic address: jf.bergmann@aphp.fr. 4. Assistance publique-hôpitaux de Paris, Saint-Louis/Lariboisière-Fernand-Widal Hospital, Department of Internal Medicine, Unit of Infectious Diseases, 2, rue Ambroise Paré, 75475 Paris cedex 10, France. Electronic address: pierre.sellier@aphp.fr.
Abstract
OBJECTIVES: Guidelines recommend routine universal HIV testing in adults to reduce the pool of infected patients unaware of their status, without specific recommendations concerning the method. We compared acceptability and feasibility of HIV testing by ELISA tests or rapid tests from finger-stick whole blood. METHODS: Prospective randomized multi-center study comparing acceptability and feasibility of routine universal HIV testing by ELISA tests, with a charge, subsequently reimbursed by Social Security for affiliated patients, or rapid tests from finger-stick whole blood, without any charge from the patients or the general practitioner for the study. A single investigator performed all interventions. After consent, all adults (18-70 years old) consulting their general practitioner in Paris, France, unaware of their status, were enrolled. Testing was performed immediately for the patients in the rapid test arm; a prescription was given for testing in a lab for the patients in the ELISA arm. The primary endpoint was acceptability of each method. The secondary endpoint was feasibility of each method, assessed one month after the consultation. RESULTS:Two hundred and seventy patients were enrolled: 133 patients in the ELISA arm, 137 in the rapid test arm. Acceptability of the rapid test (92%) was higher than that of the ELISA (63.9%), P<0.0001. Feasibility of the rapid test (100%) was higher than that of the ELISA (50.5%), P<0.0001. A center effect was shown concerning feasibility of ELISA but not concerning feasibility of rapid tests. CONCLUSION: Rapid testing from finger-stick whole blood is more acceptable and feasible than ELISA for routine universal HIV testing. A larger use of rapid tests, ideally free of charge, by general practitioners could reduce the pool of infected patients unaware of their status.
RCT Entities:
OBJECTIVES: Guidelines recommend routine universal HIV testing in adults to reduce the pool of infectedpatients unaware of their status, without specific recommendations concerning the method. We compared acceptability and feasibility of HIV testing by ELISA tests or rapid tests from finger-stick whole blood. METHODS: Prospective randomized multi-center study comparing acceptability and feasibility of routine universal HIV testing by ELISA tests, with a charge, subsequently reimbursed by Social Security for affiliated patients, or rapid tests from finger-stick whole blood, without any charge from the patients or the general practitioner for the study. A single investigator performed all interventions. After consent, all adults (18-70 years old) consulting their general practitioner in Paris, France, unaware of their status, were enrolled. Testing was performed immediately for the patients in the rapid test arm; a prescription was given for testing in a lab for the patients in the ELISA arm. The primary endpoint was acceptability of each method. The secondary endpoint was feasibility of each method, assessed one month after the consultation. RESULTS: Two hundred and seventy patients were enrolled: 133 patients in the ELISA arm, 137 in the rapid test arm. Acceptability of the rapid test (92%) was higher than that of the ELISA (63.9%), P<0.0001. Feasibility of the rapid test (100%) was higher than that of the ELISA (50.5%), P<0.0001. A center effect was shown concerning feasibility of ELISA but not concerning feasibility of rapid tests. CONCLUSION: Rapid testing from finger-stick whole blood is more acceptable and feasible than ELISA for routine universal HIV testing. A larger use of rapid tests, ideally free of charge, by general practitioners could reduce the pool of infectedpatients unaware of their status.
Authors: Qi Rui Soh; Leon Y J Oh; Eric P F Chow; Cheryl C Johnson; Muhammad S Jamil; Jason J Ong Journal: Curr HIV/AIDS Rep Date: 2022-07-13 Impact factor: 5.495