Claude T Tagny1,2, Marie Bissim3, Rolande Djeumen3, Françoise Ngo Sack4, Prisca Angandji5, Annick Ndoumba2,3, Charles Kouanfack6, Laura Eno7, Dora Mbanya1,2, Edward L Murphy8, Syria Laperche9. 1. Hematology and Blood Transfusion Service, Yaoundé University Hospital, Yaoundé, Cameroon. 2. Faculty of Medicine and Biomedical Sciences, UY1, Yaoundé, Cameroon. 3. School of Health Sciences, Catholic University of Central Africa, Yaoundé, Cameroon. 4. Blood Bank of the Yaoundé Central Hospital, Yaoundé, Cameroon. 5. Yaoundé Jamot Hospital, Yaoundé, Cameroon. 6. Yaoundé Central Hospital, Yaoundé, Cameroon. 7. The US Center for Diseases' Control, Yaoundé, Cameroon. 8. University of California, San Francisco, CA, USA. 9. National Institute of Blood Transfusion, Paris, France.
Abstract
BACKGROUND AND OBJECTIVE: In the WHO Universal test and treat strategy, false-positive HIV blood donors and patients may be unnecessarily put under antiretroviral treatment and false-negative subjects may be lost to follow-up. This study assessed the false positivity rate of the Cameroonian national HIV screening testing algorithm and the benefit of a confirmation test in the enrolment of patients and donors in the HIV care programme. METHODS: We included initial HIV reactive blood donors and patients in a cross-sectional study conducted in two Cameroonian hospitals. Samples were retested according to the Cameroon national algorithm for HIV diagnosis. A positive or discordant sample was retested with the Geenius Bio-Rad HIV 1&2 (Bio-Rad, Marnes-la-Coquette, France) for confirmation. The Geenius HIV-1-positive results with 'poor' profiles were retested for RNA as well as the Geenius indeterminate results. RESULTS: Of the 356 participants, 190/225 (84·4%) patients and 76/131 (58%) blood donors were declared positive with the national algorithm; 257 participants (96·6%) were confirmed HIV-1-positive. The study revealed that about 34/1000 blood donors and patients are false-positive and unnecessarily put on treatment; 89/1000 blood donors and patients declared discordant could have been included immediately in the HIV care programme if confirmatory testing was performed. The second test of the algorithm had a false-negative rate of 3%. Eleven samples (3·1%) were Geenius poor positive and NAT negative. CONCLUSION: The universal test and treat strategy may identify and refer more individuals to HIV care if a third rapid confirmatory test is performed for discordant cases.
BACKGROUND AND OBJECTIVE: In the WHO Universal test and treat strategy, false-positive HIV blood donors and patients may be unnecessarily put under antiretroviral treatment and false-negative subjects may be lost to follow-up. This study assessed the false positivity rate of the Cameroonian national HIV screening testing algorithm and the benefit of a confirmation test in the enrolment of patients and donors in the HIV care programme. METHODS: We included initial HIV reactive blood donors and patients in a cross-sectional study conducted in two Cameroonian hospitals. Samples were retested according to the Cameroon national algorithm for HIV diagnosis. A positive or discordant sample was retested with the Geenius Bio-RadHIV 1&2 (Bio-Rad, Marnes-la-Coquette, France) for confirmation. The Geenius HIV-1-positive results with 'poor' profiles were retested for RNA as well as the Geenius indeterminate results. RESULTS: Of the 356 participants, 190/225 (84·4%) patients and 76/131 (58%) blood donors were declared positive with the national algorithm; 257 participants (96·6%) were confirmed HIV-1-positive. The study revealed that about 34/1000 blood donors and patients are false-positive and unnecessarily put on treatment; 89/1000 blood donors and patients declared discordant could have been included immediately in the HIV care programme if confirmatory testing was performed. The second test of the algorithm had a false-negative rate of 3%. Eleven samples (3·1%) were Geenius poor positive and NAT negative. CONCLUSION: The universal test and treat strategy may identify and refer more individuals to HIV care if a third rapid confirmatory test is performed for discordant cases.
Authors: Claude T Tagny; Georges Ikomey; Françoise Ngo Sack; Celestin Achu; Matthias Ndemanou; Catherine Ninmou; Caroline Gesu; Gilbert Essomba; Alexandra Fongue Simo; Georges Nguefack Tsague; Dora Mbanya; Edward Murphy Journal: Vox Sang Date: 2022-03-17 Impact factor: 2.996