The Performance of the Current Algorithm of HIV Diagnosis

Abdurrahman  Gulmez; Ozgur  Appak; Arzu Nazli  Zeka; Nuran  Esen; Ayca Arzu  Sayiner

doi:10.18502/ijph.v53i7.16051

Abdurrahman Gulmez Istanbul Basaksehir Cam and Sakura City Hospital, Medical Microbiology Laboratory, Istanbul, Turkey
Ozgur Appak Department of Medical Microbiology, Faculty of Medicine, Virology Unit, Dokuz Eylul University, Izmir, Turkey
Arzu Nazli Zeka Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
Nuran Esen Department of Medical Microbiology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
Ayca Arzu Sayiner Department of Medical Microbiology, Faculty of Medicine, Virology Unit, Dokuz Eylul University, Izmir, Turkey

DOI: https://doi.org/10.18502/ijph.v53i7.16051

Keywords: HIV infection diagnosis; Serodiagnosis; Algorithms; Testing HIV

Abstract

Background: We aimed to evaluate the performance of the current algorithm the HIV diagnosis that has been performed for four years. Results of HIV Ag/Ab tests, anti-HIV 1/2 confirmatory tests, HIV-1 RNA tests and the time for official results to be approved were evaluated.

Methods: The relationship of HIV Ag/Ab tests, anti-HIV 1/2 confirmation tests and HIV-1 RNA PCR tests, their result times and suitability to the algorithm were examined at Izmir Dokuz Eylül University between May 2017 and June 2021.

Results: HIV Ag/Ab ELISA was reactive repetitively in 165/54628 (0.30%) serum samples. Anti-HIV 1/2 confir-mation test was reactive in 54.42% (80/147) of samples. The most common pattern (18.2%) in the con-firmation tests was the positivity of the antibodies against gp160 - gp41 envelope glycoproteins together. The mean reporting time of the confirmation test result was 3h 50 min after the ELISA test. The mean reporting time of the HIV-1 RNA PCR was 12.79 d (±10.22) after the ELISA test and 12.63 (± 10.12) day after the confirmation test. In ROC analysis, the estimated rate of the ELISA test for the confirmation test was highest when S/CO was >13.16 (sensitivity: 97.59 %, specificity: 97.59%).

Conclusion: The confirmation test in the current algorithm enabled the rapid test results, early diagnosis of HIV and early antiretroviral therapy. To use the new algorithm effectively, decentralization of the validation tests would be appropriate.