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Sample records for hiv serologic testing

  1. Testing bias in calculating HIV incidence from the Serologic Testing Algorithm for Recent HIV Seroconversion.

    PubMed

    Remis, Robert S; Palmer, Robert W H

    2009-02-20

    Incidence is critical in monitoring HIV infection in populations but often difficult to measure. The Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS) can estimate HIV incidence from a single specimen at low cost. Nevertheless, HIV testing patterns may introduce bias, rendering interpretation of the STARHS result problematic. We found empirical evidence of such bias in Ontario using the STARHS formula with varied window periods In a hypothetical population of homosexual men, we calculated HIV incidence from the STARHS assay on the basis of incidence density, study duration, STARHS window period and intertest interval. We also incorporated the increased likelihood of a newly infected person having an HIV test due to seroconversion illness or high-risk behaviours ('seroconversion effect' or SCE). We also varied the intertest interval inversely as a function of incidence density. To adjust incidence estimates for bias, we fit empirical STARHS data to an algebraic formula expressing measured HIV incidence as a function of SCE and incidence. Incidence density estimates were unbiased when SCE or incidence density-interval interactions were absent. However, estimated incidence density was higher than true incidence density in the presence of SCE, as much as seven-fold higher under certain conditions. The goodness-of-fit provided estimates with an excellent fit, yielding plausible results. HIV incidence from STARHS may be strongly biased because of early testing in recently infected persons, resulting in substantial overestimation, at least amongst men who have sex with men. Thus, incidence estimates from STARHS must be interpreted with considerable caution. Nevertheless, incidence estimates may be adjusted to yield unbiased results.

  2. Diagnostic Value of Culture and Serological Tests in the Diagnosis of Histoplasmosis in HIV and non-HIV Colombian Patients

    PubMed Central

    Arango-Bustamante, Karen; Restrepo, Angela; Cano, Luz Elena; de Bedout, Catalina; Tobón, Angela Maria; González, Angel

    2013-01-01

    We determined the value of culture and serological tests used to diagnose histoplasmosis. The medical records of 391 histoplasmosis patients were analyzed. Diagnosis of the mycosis was assessed by culture, complement fixation, and immunodiffusion tests; 310 patients (79.5%) were male, and 184 patients (47.1%) were infected with human immunodeficiency virus (HIV). Positivity value for cultures was 35.7% (74/207), reactivity of serological tests was 95.2% (160/168), and a combination of both methodologies was 16.9% (35/207) for non-HIV patients. Positivity value for cultures was 75.0% (138/184), reactivity of serological tests was 92.4% (85/92), and a combination of both methodologies was 26.0% (48/184) for HIV/acquired immunodeficiency syndrome (AIDS) patients; 48.1% (102/212) of extrapulmonary samples from HIV/AIDS patients yielded positive cultures compared with 23.1% (49/212) in non-HIV patients. Lymphocyte counts made for 33.1% (61/184) of HIV/AIDS patients showed a trend to low CD4+ numbers and higher proportion of positive cultures. These results indicate that culture is the most reliable fungal diagnostic method for HIV/AIDS patients, and contrary to what is generally believed, serological assays are useful for diagnosing histoplasmosis in these patients. PMID:24043688

  3. Diagnostic value of culture and serological tests in the diagnosis of histoplasmosis in HIV and non-HIV Colombian patients.

    PubMed

    Arango-Bustamante, Karen; Restrepo, Angela; Cano, Luz Elena; de Bedout, Catalina; Tobón, Angela Maria; González, Angel

    2013-11-01

    We determined the value of culture and serological tests used to diagnose histoplasmosis. The medical records of 391 histoplasmosis patients were analyzed. Diagnosis of the mycosis was assessed by culture, complement fixation, and immunodiffusion tests; 310 patients (79.5%) were male, and 184 patients (47.1%) were infected with human immunodeficiency virus (HIV). Positivity value for cultures was 35.7% (74/207), reactivity of serological tests was 95.2% (160/168), and a combination of both methodologies was 16.9% (35/207) for non-HIV patients. Positivity value for cultures was 75.0% (138/184), reactivity of serological tests was 92.4% (85/92), and a combination of both methodologies was 26.0% (48/184) for HIV/acquired immunodeficiency syndrome (AIDS) patients; 48.1% (102/212) of extrapulmonary samples from HIV/AIDS patients yielded positive cultures compared with 23.1% (49/212) in non-HIV patients. Lymphocyte counts made for 33.1% (61/184) of HIV/AIDS patients showed a trend to low CD4+ numbers and higher proportion of positive cultures. These results indicate that culture is the most reliable fungal diagnostic method for HIV/AIDS patients, and contrary to what is generally believed, serological assays are useful for diagnosing histoplasmosis in these patients.

  4. Interpopulation variation in HIV testing promptness may introduce bias in HIV incidence estimates using the serologic testing algorithm for recent HIV seroconversion.

    PubMed

    White, Edward; Goldbaum, Gary; Goodreau, Steven; Lumley, Thomas; Hawes, Stephen E

    2010-08-01

    The serologic testing algorithm for recent HIV seroconversion (STARHS) calculates incidence using the proportion of testers who produce a level of HIV antibody high enough to be detected by ELISA but low enough to suggest recent infection. The validity of STARHS relies on independence between dates of HIV infection and dates of antibody testing. When subjects choose the time of their own test, testing may be motivated by risky behaviour or symptoms of infection and the criterion may not be met. This analysis was conducted to ascertain whether estimates of incidence derived using STARHS were consistent with estimates derived using a method more robust against motivated testing. A cohort-based incidence estimator and two STARHS methods were applied to identical populations (n=3821) tested for HIV antibody at publicly funded sites in Seattle. Overall seroincidence estimates, demographically stratified estimates and incidence rate ratios were compared across methods. The proportion of low-antibody testers among HIV-infected individuals was compared with the proportion expected given their testing histories. STARHS estimates generally exceeded cohort-based estimates. Incidence ratios derived using STARHS between demographic strata were not consistent across methods. The proportion of HIV-infected individuals with lower antibody levels exceeded that which would be expected under independence between infection and testing. Incidence estimates and incidence rate ratios derived using methods that rely on the changing antibody level over the course of HIV infection may be vulnerable to bias when applied to populations who choose the time of their own testing.

  5. Field evaluation of rapid HIV serologic tests for screening and confirming HIV-1 infection in Honduras.

    PubMed

    Stetler, H C; Granade, T C; Nunez, C A; Meza, R; Terrell, S; Amador, L; George, J R

    1997-03-01

    To determine the ability of simple, rapid tests to identify HIV-1 antibody-positive specimens in field settings using the World Health Organization's (WHO) alternative testing strategies. Three-phase evaluation of simple, rapid assays using banked specimens and prospectively collected serum specimens at regional hospitals and rural clinics. Seven test (Retrocell, Genie, HIVCHEK, SUDS HIV-1, Testpack, Serodia HIV-1, and HIV-1/2 RTD) were evaluated and results compared with standard enzyme immunoassay (EIA) and Western blot results (phase 1). Further evaluation consisted of prospective testing of routine specimens at regional (phase 2; n = 900) and rural, peripheral laboratories (phase 3; n = 1266) throughout Honduras with selected assays. Sensitivity and specificity were calculated for each assay and combination of assays for each phase to evaluate the effectiveness of the WHO alternative testing strategies. All tests in all phases were > 99% sensitive after correcting for technical errors, with two exceptions (SUDS, phase 1; HIVCHEK, phase 3). In phase 3, where the testing algorithm was diagnostic, several combinations of assays were 100% sensitive and specific using WHO strategy II or III. For the Honduras Ministry of Health, the combination of Retrocell and Genie was found to be equally sensitive, more specific (no indeterminate results), and less expensive than EIA/Western blot. Combinations of rapid, simple HIV antibody assays provide sensitivity and specificity performance comparable to EIA/Western blot. Application of these combinations in the WHO alternative testing strategies provides an inexpensive and effective method of determining HIV status. Assay combinations using these strategies can be easily performed in small, rural laboratories and have been implemented in routine HIV screening in Honduras.

  6. Campylobacter serology test

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/003530.htm Campylobacter serology test To use the sharing features on this page, please enable JavaScript. Campylobacter serology test is a blood test to look ...

  7. HIV Antibody Test

    MedlinePlus

    ... AACC products and services. Advertising & Sponsorship: Policy | Opportunities HIV Antibody and HIV Antigen (p24) Share this page: Was this page helpful? Also known as: HIV Screening Tests; AIDS Test; AIDS Screen; HIV Serology; ...

  8. Field Evaluation of a Rapid Human Immunodeficiency Virus (HIV) Serial Serologic Testing Algorithm for Diagnosis and Differentiation of HIV Type 1 (HIV-1), HIV-2, and Dual HIV-1-HIV-2 Infections in West African Pregnant Women

    PubMed Central

    Rouet, François; Ekouevi, Didier K.; Inwoley, André; Chaix, Marie-Laure; Burgard, Marianne; Bequet, Laurence; Viho, Ida; Leroy, Valériane; Simon, François; Dabis, François; Rouzioux, Christine

    2004-01-01

    We evaluated a two-rapid-test serial algorithm using the Determine and Genie II rapid assays, performed on-site in four peripheral laboratories during the French Agence Nationale de Recherches sur le SIDA (ANRS) 1201/1202 Ditrame Plus cohort developed for prevention of mother-to-child transmission of human immunodeficiency virus (HIV) infection in Côte d'Ivoire. A total of 1,039 specimens were retested by two commercial enzyme-linked immunosorbent assays (ELISAs). The following specimens were tested: 315 specimens found on-site to be infected with HIV type 1 (HIV-1), 8 specimens found on-site to be infected with HIV-2, 71 specimens found on-site to be infected with both HIV-1 and HIV-2, 40 specimens found on-site to have indeterminate results for HIV infection, and 605 specimens taken during a quality assurance program. For HIV discrimination, 99 positive serum samples (20 with HIV-1, 8 with HIV-2, and 71 with HIV-1 and HIV-2 on the basis of our rapid test algorithm) were retested by the Peptilav test, Western blot (WB) assays, and homemade monospecific ELISAs. Real-time DNA PCRs for the detection of HIV-1 and HIV-2 were performed with peripheral blood mononuclear cells from 35 women diagnosed on-site with HIV-1 and HIV-2 infections. Compared to the results of the ELISAs, the sensitivities of the Determine and Genie II assays were 100% (95% lower limit [95% LL], 99.1%) and 99.5% (95% confidence interval [95% CI], 98.2 to 99.9%), respectively. The specificities were 98.4% (95% CI, 96.9 to 99.3%) and 100% (95% LL, 99.3%), respectively. All serological assays gave concordant results for infections with single types. By contrast, for samples found to be infected with dual HIV types by the Genie II assay, dual reactivity was detected for only 37 samples (52.1%) by WB assays, 34 samples (47.9%) by the Peptilav assay, and 23 samples (32.4%) by the monospecific ELISAs. For specimens with dual reactivity by the Genie II assay, the rates of concordance between the real

  9. HIV Incidence Among Injection Drug Users in New York City, 1990 to 2002: Use of Serologic Test Algorithm to Assess Expansion of HIV Prevention Services

    PubMed Central

    Des Jarlais, Don C.; Perlis, Theresa; Arasteh, Kamyar; Torian, Lucia V.; Beatrice, Sara; Milliken, Judith; Mildvan, Donna; Yancovitz, Stanley; Friedman, Samuel R.

    2005-01-01

    Objectives. We sought to estimate HIV incidence among injection drug users (IDUs) in New York City from 1990 to 2002 to assess the impact of an expansion of syringe exchange services. Syringe exchange increased greatly during this period, from 250000 to 3000000 syringes exchanged annually. Methods. Serum samples were obtained from serial cross-sectional surveys of 3651 IDUs. HIV-positive samples were tested with the Serologic Test Algorithm for Recent HIV Seroconversion (STARHS) assay to identify recent HIV infections and to estimate HIV incidence. Consistency with other incidence studies was used to assess strengths and limitations of STARHS. Results. HIV incidence declined from 3.55/100 person-years at risk (PYAR) from 1990–1992, to 2.63/100 PYAR from 1993–1995, to 1.05/100 PYAR from 1996–1998, and to 0.77/100 PYAR from 1999–2002 (P<.001). There was a very strong negative linear relationship (r= −.99, P<.005) between the annual numbers of syringes exchanged and estimated HIV incidence. These results were highly consistent with a large number of shorter incidence studies among IDUs conducted during the time period. Conclusions. STARHS testing of samples from large serial cross-sectional surveys can provide important data for the assessment of community-level HIV prevention. PMID:15985649

  10. Electroaddressed immobilization of recombinant HIV-1 P24 capsid protein onto screen-printed arrays for serological testing.

    PubMed

    Marquette, Christophe A; Imbert-Laurenceau, Emmanuelle; Mallet, Francois; Chaix, Carole; Mandrand, Bernard; Blum, Loïc J

    2005-05-01

    A serological chemiluminescent biochip was designed based on screen-printed electrode arrays composed of nine 1-mm(2) electrodes. Arrays were shown to be produced with good batch-to-batch reproducibility (standard deviations of 4.4 and 12.0% for ferricyanide oxidation potential and current, respectively) and very good reproducibility within a particular array (2.0 and 7.5% standard deviations for the same controls). Electrode arrays were used to electroaddress various bioconjugate structures comprising a recombinant HIV-1 P24 capsid protein (RH24K) in polypyrrole film. Entrapment of RH24K preimmobilized onto maleic anhydride-alt-methyl vinyl ether copolymer was shown to be the more efficient immobilization procedure. This addressed sensing layer enabled the detection of anti-P24 antibodies at a concentration of 3.5 ng/ml through peroxidase-labeled anti-human immunoglobulin G reaction. The biochip was used to perform an HIV-1 serological test in human sera. HIV-1 seropositive and seronegative sera were easily discriminated using serum dilutions greater than 1/10,000.

  11. Deceased tissue donor serology and molecular testing for HIV, hepatitis B and hepatitis C viruses: a lack of cadaveric validated tests.

    PubMed

    Victer, Thayssa Neiva da Fonseca; Dos Santos, Cris Stéphany Rodrigues; Báo, Sônia Nair; Sampaio, Thatiane Lima

    2016-12-01

    Vital to patient safety is the accurate assessment and minimization of risk for human immunodeficiency virus (HIV), Hepatitis C (HCV), and Hepatitis B (HBV) virus transmission by deceased donor organ and tissue transplantation. The pathogens are tested by serological kits based on enzyme-linked immunosorbent assay (ELISA), chemiluminescence (CLIA) and eletrochemiluminescence (ECLIA) immunoassays. Organ transplantation is a highly successful life-saving treatment in Brazil, but the Brazilian Health Surveillance Agency currently mandates that all deceased organ donors are screened for HIV, HCV and HBV following living donor policies. In this review, six ELISA (Wama(®), Bio-Rad(®), Biomerieux(®), DiaSorin(®), Acon Biotech(®) and Biokit(®)), three CLIA (Abbott(®), Siemens(®), Diasorin(®)) and one ECLIA (Roche(®)) were utilized for evaluating the effectiveness of those serological tests for deceased donors in Brazil according to manufacturer's guidelines. NAT for HIV, HCV and HBV can assist with detection of pre-seroconversion for those infections, and only Cobas(®) TaqScreen MPX(®) test, the Tigris System(®) Procleix Ultrio Assay(®) and the Bio-Manguinhos(®) HIV/HCV/HBV NAT are commercially available. Between all the tests, only the manufacturer Abbott(®) and Cobas(®) TaqScreen MPX(®) test are currently validated for cadaver samples.

  12. Identifying Recent HIV Infections: From Serological Assays to Genomics

    PubMed Central

    Moyo, Sikhulile; Wilkinson, Eduan; Novitsky, Vladimir; Vandormael, Alain; Gaseitsiwe, Simani; Essex, Max; Engelbrecht, Susan; de Oliveira, Tulio

    2015-01-01

    In this paper, we review serological and molecular based methods to identify HIV infection recency. The accurate identification of recent HIV infection continues to be an important research area and has implications for HIV prevention and treatment interventions. Longitudinal cohorts that follow HIV negative individuals over time are the current gold standard approach, but they are logistically challenging, time consuming and an expensive enterprise. Methods that utilize cross-sectional testing and biomarker information have become an affordable alternative to the longitudinal approach. These methods use well-characterized biological makers to differentiate between recent and established HIV infections. However, recent results have identified a number of limitations in serological based assays that are sensitive to the variability in immune responses modulated by HIV subtypes, viral load and antiretroviral therapy. Molecular methods that explore the dynamics between the timing of infection and viral evolution are now emerging as a promising approach. The combination of serological and molecular methods may provide a good solution to identify recent HIV infection in cross-sectional data. As part of this review, we present the advantages and limitations of serological and molecular based methods and their potential complementary role for the identification of HIV infection recency. PMID:26512688

  13. Identifying Recent HIV Infections: From Serological Assays to Genomics.

    PubMed

    Moyo, Sikhulile; Wilkinson, Eduan; Novitsky, Vladimir; Vandormael, Alain; Gaseitsiwe, Simani; Essex, Max; Engelbrecht, Susan; de Oliveira, Tulio

    2015-10-23

    In this paper, we review serological and molecular based methods to identify HIV infection recency. The accurate identification of recent HIV infection continues to be an important research area and has implications for HIV prevention and treatment interventions. Longitudinal cohorts that follow HIV negative individuals over time are the current gold standard approach, but they are logistically challenging, time consuming and an expensive enterprise. Methods that utilize cross-sectional testing and biomarker information have become an affordable alternative to the longitudinal approach. These methods use well-characterized biological makers to differentiate between recent and established HIV infections. However, recent results have identified a number of limitations in serological based assays that are sensitive to the variability in immune responses modulated by HIV subtypes, viral load and antiretroviral therapy. Molecular methods that explore the dynamics between the timing of infection and viral evolution are now emerging as a promising approach. The combination of serological and molecular methods may provide a good solution to identify recent HIV infection in cross-sectional data. As part of this review, we present the advantages and limitations of serological and molecular based methods and their potential complementary role for the identification of HIV infection recency.

  14. [Association of oral lesions with HIV serological status].

    PubMed

    Ramírez-Amador, Velia; Esquivel-Pedraza, Lilly; Irigoyen-Camacho, Esther; Anaya-Saavedra, Gabriela; González-Ramírez, Imelda

    2002-01-01

    To estimate the prevalence of oral lesions and its association with HIV serological status. A cross-sectional descriptive study was conducted between 1998 and 1999 in Mexico City, among 512 subjects attending two information centers of Centro Nacional para la Prevención del VIH/SIDA e ITS (CONASIDA, National Center for Prevention of HIV/AIDS and Sexually Transmitted Infections) for HIV serologic testing. The oral examination was performed without knowledge of the HIV status. Statistical analysis was conducted using Student's t test, Fisher's exact test and the chi 2 test; odds ratios and 95% CI were also calculated. A total of 512 individuals were examined, 68 of whom were HIV-positive. HIV-related oral lesions (OL), were evident in 65% (44/68) of the HIV-positive individuals; 95% of them consisted in oral candidosis (OC) and hairy leukoplakia (HL). OC and HL were strongly associated with seropositivity to HIV. OC and HL were the oral lesions most strongly associated to HIV seropositivity. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

  15. Serological diagnosis of paracoccidioidomycosis in HIV-coinfected patients.

    PubMed

    Bellissimo-Rodrigues, Fernando; Vitali, Lucia Helena; Martinez, Roberto

    2010-11-01

    Paracoccidioidomycosis should be differentiated from other opportunistic diseases in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients who live in Latin America. Laboratory investigation can begin with serological tests, which are rapid and efficient. In the present study, double immunodiffusion (DID), counterimmunoelectrophoresis (CIEP) and an enzyme linked immunosorbent assay (ELISA) tests were assessed for the detection of anti-Paracoccidioides brasiliensis antibodies in 40 patients coinfected with HIV. The results were compared to those obtained for 75 non-HIV-infected patients with endemic paracoccidioidomycosis. Anti-P. brasiliensis antibodies were detected in 65% (DID), 79% (CIEP) and 95% (ELISA) of the patients with HIV/AIDS, significantly lower rates than those detected in cases of endemic paracoccidioidomycosis, which were 89%, 99% and 100%, respectively. The reactive sera of HIV-infected patients also showed lower anti-P. brasiliensis antibody titres than those of non-HIV-infected patients. Despite the lower intensity of the specific humoral response, serological tests are useful for the diagnosis of opportunistic paracoccidioidomycosis in the HIV/AIDS population. We suggest optimization of the laboratory diagnosis by combining the ELISA test with CIEP or DID.

  16. CMV serology test

    MedlinePlus

    ... transplant recipients and people with a suppressed immune system). The test may also be performed ... laboratories. Some labs use different measurements or test different samples. Talk to your doctor ...

  17. HIV Testing

    MedlinePlus

    ... antibody tests, combination or fourth-generation tests, and nucleic acid tests (NAT). HIV tests may be performed on ... retested 3 months after your possible exposure. A nucleic acid test (NAT) looks for HIV in the blood. ...

  18. Serological diagnosis of HIV infection using oral fluid samples.

    PubMed Central

    Tamashiro, H.; Constantine, N. T.

    1994-01-01

    The serological identification of antibodies to human immunodeficiency virus (HIV) in blood is the most widely used method to diagnose HIV infection. Recently, however, the use of oral fluid samples for the detection of antibodies to HIV has been suggested as an alternative. This review describes some basic information about oral fluids, the application of these samples for HIV testing, and summarizes results from many of the studies performed using HIV tests with oral fluids. The fluids obtained from the oral cavity include saliva and crevicular fluid, and can be collected directly (by dribbling) or by using commercially available devices. The immunoglobulin content of oral fluids is similar to that of blood, but their levels are less. However, the use of an HIV IgG antibody capture assay (GAC ELISA) designed specifically for testing oral fluids, and certain routine HIV blood tests that have been optimized for use with oral fluids, has produced encouraging results. A number of studies, including several in developing countries, report that the sensitivities and specificities of these optimized tests lie in the range 95-100% and 98-100%, respectively. Also, the performance of the GAC ELISA was consistent and in general, excellent. The article identifies several issues that need to be addressed before a recommendation on the routine use of oral fluid samples for HIV antibody detection can be made. PMID:8131250

  19. Serologic testing in celiac disease

    PubMed Central

    Rashid, Mohsin; Lee, Jennie

    2016-01-01

    Abstract Objective To address the questions and challenges commonly faced by primary care physicians when ordering serologic tests for celiac disease (CD) and provide practical clinical tips to help in the interpretation of test results. Sources of information MEDLINE was searched from 2000 to 2015 for English-language guidelines on the diagnosis and management of CD published by professional gastroenterological organizations. Main message To screen patients for CD, measurement of the immunoglobulin A (IgA) tissue transglutaminase antibody is the preferred test. Total serum IgA level should be measured to exclude selective IgA deficiency and to avoid false-negative test results. Patients with positive serologic test results should be referred to a gastroenterologist for endoscopic small intestinal biopsies to confirm the diagnosis. Testing for human leukocyte antigens DQ2 and DQ8 can help exclude the diagnosis. A gluten-free diet should not be started before confirming the diagnosis of CD. Conclusion Serologic testing is very useful for screening patients with suspected CD. Early diagnosis is essential to prevent complications of CD. PMID:26796833

  20. Disclosure of HSV-2 Serological Test Results in the Context of an Adolescent HIV Prevention Trial in Kenya

    PubMed Central

    Hallfors, Denise Dion; Cho, Hyunsan; Mbai, Isabella; Millimo, Benson; Atieno, Carolyne; Okumu, David; Luseno, Winnie; Hartman, Shane; Halpern, Carolyn T.; Hobbs, Marcia M.

    2015-01-01

    Objectives HSV-2 biomarkers are often used in adolescent sub-Saharan HIV prevention studies, but evaluations of test performance and disclosure outcomes are rare in the published literature. Therefore, we investigated the proportion of ELISA-positive and indeterminant samples confirmed by Western blot (WB); the psychosocial response to disclosure; and whether reports of sexual behavior and HSV-2 symptoms are consistent with WB confirmatory results among adolescent orphans in Kenya. Methods In 2011, 837 Kenyan orphan youth in grades 7 and 8 enrolled in an HIV prevention clinical trial with HSV-2 biomarker outcomes. We used a modified algorithm for the Kalon HSV-2 ELISA to improve specificity; positive and indeterminate results were WB-tested. We developed culturally sensitive protocols for disclosing positive results and documented psychosocial responses, reports of sexual contact, and HSV-2 symptoms. Results 28 adolescents (3.3%) were identified as HSV-2 seropositive; 6 as indeterminate. Of these, 22 positive and all indeterminants were WB-tested; 20 and 5, respectively, were confirmed positive. Most youth reported moderate brief stress after disclosure; 22% reported longer and more severe distress. Boys were more likely to be in the latter category. Self-reported virginity was highly inconsistent with WB confirmed positives. Conclusions The higher than manufacturer cut-off for Kalon ELISA modestly reduced the rate of false positive test results but also increased false negatives. Investigators should consider the risk-benefit ratio in deciding whether or not to disclose HSV-2 results to adolescent participants under specific field conditions. PMID:26139208

  1. A serological test in tuberculosis

    PubMed Central

    Zykov, M. P.; Geser, A.; Egsmose, T.; Godovannyi, B. A.; Donets, I.; Ang'awa, J. A. W.; Patel, R. I.; Bløcher, C.; Poti, S. J.

    1966-01-01

    Takahashi reported in 1962 that his kaolin-agglutination test (KAT), using the phosphatide fraction of Mycobacterium tuberculosis as antigen, was capable of detecting specific antibodies in sera from patients with pulmonary tuberculosis, and that the test could differentiate between active and inactive disease. The present study was designed to investigate the diagnostic efficiency of the KAT under conditions that prevail in Africa. Blood specimens were obtained from various categories of people, ranging from presumably healthy tuberculin-negative persons to patients with far-advanced pulmonary tuberculosis, and these specimens were submitted ”blindly” for serological testing. The results showed that the KAT was less sensitive and also less specific in Kenya than it had been found in Japan by Takahashi. Some reasons for this discrepancy are discussed, but no final conclusion is reached. PMID:5335460

  2. HIV/HBV coinfection: Serological control and therapeutic strategies.

    PubMed

    Ruiz-Artacho, P; Téllez-Molina, M J; Vergas-García, J; Altali-Alhames, K; Estrada-Pérez, V; Fernández-Cruz-Pérez, A

    2013-01-01

    The evolution and prognosis of patients co-infected by human immunodeficiency virus (HIV) and hepatitis B (HBV) is not well know. This study describes the treatment and serological, virological and biochemical and elastographic responses of HIV and HBV-coinfected patients. A descriptive, retrospective study of all the HIV/HBV-coinfected patients seen in a specialized HIV department between 1 January 2007 and 30 November 2008 was performed. Virological and serological determinations of HIV and HBV infections as well as CD4 lymphocytes and transaminases prior to antiretroviral treatment and at the time of analysis were obtained. A total of 54 (5.4%) cases of HIV/HBV coinfection were identified. The median nadir and current CD4 were 179 and 437 cells/L, respectively. There was undetectable RNA-HIV in 70%. There were 52 patients (96.3%) who followed active drugs treatment against HBV. After treatment, 68.8% had HBeAg negative result, with 81.6% virologic response. The HBsAg became negative in 10.4%. ALT was normal in 75.5%. FibroScan(®) was performed in 30 (55.6%) patients, yielding a median of 7.0kPa. The results obtained suggest a good serological, virological and biochemical control of HIV/HBV-coinfected patients with treatments recommended by clinical guidelines. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  3. HIV/HBV coinfection: serological control and therapeutic strategies.

    PubMed

    Ruiz-Artacho, P; Téllez-Molina, M J; Vergas-García, J; Altali-Alhames, K; Estrada-Pérez, V; Fernández-Cruz-Pérez, A

    2013-01-01

    The evolution and prognosis of patients co-infected by human immunodeficiency virus (HIV) and hepatitis B (HBV) is not well know. This study describes the treatment and serological, virological and biochemical and elastographic responses of HIV and HBV-coinfected patients. A descriptive, retrospective study of all the HIV/HBV-coinfected patients seen in a specialized HIV department between 1 January 2007 and 30 November 2008 was performed. Virological and serological determinations of HIV and HBV infections as well as CD4 lymphocytes and transaminases prior to antiretroviral treatment and at the time of analysis were obtained. A total of 54 (5.4%) cases of HIV/HBV coinfection were identified. The median nadir and current CD4 were 179 and 437 cells/L, respectively. There was undetectable RNA-HIV in 70%. There were 52 patients (96.3%) who followed active drugs treatment against HBV. After treatment, 68.8% had HBeAg negative result, with 81.6% virologic response. The HBsAg became negative in 10.4%. ALT was normal in 75.5%. FibroScan(®) was performed in 30 (55.6%) patients, yielding a median of 7.0kPa. The results obtained suggest a good serological, virological and biochemical control of HIV/HBV-coinfected patients with treatments recommended by clinical guidelines. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  4. Relative performance of Organon kit in comparison to Du Pont for confirmatory serological testing of HIV infection by western blot test in sera from blood donors.

    PubMed

    Aggarwal, R K; Chatterjee, R; Chattopadhya, D; Kumari, S

    1992-06-01

    A total of 32 specimens with different categories of reactivity by Du Pont Western Blot kit comprising of specimens showing full spectrum of HIV-I antigen specific bands, 19 specimens showing total absence of bands and four specimens showing non-specific bands (without any interpretative importance) were subjected to Western Blot testing by Organon test. Of the nine specimens showing full spectrum of bands by Du Pont the correlation with Organon kit was 100 per cent based on WHO criteria. Four specimens with non-specific indeterminate band pattern by Du Pont failed to show any band in Organon kit, indicating that latter to be more specific.

  5. Anti-HIV antibodies in the CSF of AIDS patients: a serological and immunoblotting study.

    PubMed Central

    Bukasa, K S; Sindic, C J; Bodeus, M; Burtonboy, G; Laterre, C; Sonnet, J

    1988-01-01

    CSF and serum samples from 16 AIDS patients were tested for the presence of anti-HIV antibodies either by classical serological methods or by an immunoblot technique based on agarose gel isoelectric focusing and transfer of the specific IgG antibodies onto HIV antigens-loaded nitrocellulose sheets. This method enabled the demonstration of an intrathecal synthesis of anti-HIV oligoclonal IgG antibodies, often superimposed on diffuse polyclonal production, in 14 patients. The two negative cases were devoid of neurological signs or symptoms. However, two patients classified in stage II of the disease (asymptomatic infection) displayed an intrathecal synthesis of anti-HIV antibodies. Images PMID:3216207

  6. Serological and molecular markers of hepatitis E virus infection in HIV-infected patients in Brazil.

    PubMed

    Ferreira, A C; Gomes-Gouvêa, Michele Soares; Lisboa-Neto, G; Mendes-Correa, M C J; Picone, C M; Salles, N A; Mendrone-Junior, A; Carrilho, F J; Pinho, J R R

    2017-09-30

    In Brazil, the circulation of hepatitis E virus (HEV) has been demonstrated in distinct groups of individuals and some animals, but its prevalence among individuals with human immunodeficiency virus (HIV) infection is unknown. This study aimed to assess the frequency of serological and molecular HEV markers in individuals infected with HIV from São Paulo, Brazil. Serum and plasma samples of 354 HIV-infected patients collected between 2007 and 2013 were included. All samples were tested for anti-HEV IgG and IgM antibodies and HEV RNA. Anti-HEV IgG and IgM antibodies were detected in 10.7% (38/354) and 1.4% (5/354) of the samples, respectively. Both antibodies were detected simultaneously in only two samples. HEV RNA was not detected in any sample. There was no significant correlation of anti-HEV serological status (positivity to anti-HEV IgG and/or IgM) with sex, age, CD4(+) T cell count, HIV viral load, antiretroviral therapy, liver enzyme levels, or coinfection with hepatitis B virus and/or hepatitis C virus. Our study provides serological evidence of past and recent HEV infections in HIV-infected patients from São Paulo, Brazil. However, the occurrence of ongoing HEV infection appears be a rare event in this population.

  7. Measles, mumps, rubella and VZV: importance of serological testing of vaccine-preventable diseases in young adults living with HIV in Germany.

    PubMed

    Schwarze-Zander, C; Draenert, R; Lehmann, C; Stecher, M; Boesecke, C; Sammet, S; Wasmuth, J C; Seybold, U; Gillor, D; Wieland, U; Kümmerle, T; Strassburg, C P; Mankertz, A; Eis-Hübinger, A M; Jäger, G; Fätkenheuer, G; Bogner, J R; Rockstroh, J K; Vehreschild, J J

    2017-01-01

    Measles, mumps, rubella (MMR) and varicella zoster virus (VZV) infection can cause serious diseases and complications in the HIV-positive population. Due to successful vaccination programmes measles, mumps and congenital rubella syndrome has become neglected in Germany. However, recent outbreaks of measles have occurred from import-associated cases. In this cross-sectional study the serostatus for MMR and VZV in 2013 HIV-positive adults from three different university outpatient clinics in Bonn (n = 544), Cologne (n = 995) and Munich (n = 474) was analysed. Sera were tested for MMR- and VZV-specific immunglobulin G antibodies using commercial immunoassays. Seronegativity was found in 3% for measles, 26% for mumps, 11% for rubella and 2% for VZV. Regarding MMR, 35% of patients lacked seropositivity against at least one infectious agent. In multivariable analysis younger age was strongly associated with seronegativity against all four viruses, measles, mumps, rubella (P < 0·001, P < 0·001 and P = 0·001, respectively) and VZV (P = 0·001). In conclusion, there is high need for MMR and VZV vaccination in people living with HIV in Germany born in 1970 or later. Thus, systematic MMR and VZV antibody screening and vaccination should be implemented in the HIV-positive population to prevent serious disease and complications of vaccine-preventable diseases.

  8. Comparison of Parasitological, Serological, and Molecular Tests for Visceral Leishmaniasis in HIV-Infected Patients: A Cross-Sectional Delayed-Type Study

    PubMed Central

    Cota, Gláucia Fernandes; de Sousa, Marcos Roberto; de Freitas Nogueira, Betânia Mara; Gomes, Luciana Inácia; Oliveira, Edward; Assis, Tália Santana Machado; de Mendonça, Andréa Laender Pessoa; Pinto, Bruna Fernandes; Saliba, Juliana Wilke; Rabello, Ana

    2013-01-01

    The aim of this study was to evaluate the accuracy of invasive and non-invasive tests for diagnosis of visceral leishmaniasis (VL) in a large series of human immunodeficiency virus (HIV)-infected patients. In this delayed-type cross-sectional study, 113 HIV-infected symptomatic patients were evaluated by an adjudication committee after clinical follow-up to establish the presence or absence of VL as the target condition (reference test). The index tests were recombinant K39 antigen-based immunochromatographic test (rK39), indirect fluorescent antibody test (IFAT), prototype kit of direct agglutination test (DAT-LPC), and real-time polymerase chain reaction (qPCR) in peripheral blood. Compared with parasitological test and adjudication committee diagnosis or latent class model analyses, IFAT and rk39 dipstick test presented the lowest sensitivity. DAT-LPC exhibited good overall performance, and there was no statistical difference between DAT-LPC and qPCR diagnosis accuracy. Real-time PCR emerges as a less invasive alternative to parasitological examination for confirmation of cases not identified by DAT. PMID:23836568

  9. Testing for HIV

    MedlinePlus

    ... Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products Vaccines, Blood & Biologics Home Vaccines, Blood & Biologics Safety & Availability (Biologics) HIV Home Test Kits Testing for HIV Share Tweet Linkedin Pin it More ...

  10. Direct agglutination test for serologic diagnosis of Neospora caninum infection.

    PubMed

    Romand, S; Thulliez, P; Dubey, J P

    1998-01-01

    A direct agglutination test was evaluated for the detection and quantitation of IgG antibodies to Neospora caninum in both experimental and natural infections in various animal species. As compared with results obtained by the indirect fluorescent antibody test, the direct agglutination test appeared reliable for the serologic diagnosis of neosporosis in a variety of animal species. The direct agglutination test should provide easily available and inexpensive tools for serologic testing for antibodies to N. caninum in many host species.

  11. HIV testing in Switzerland.

    PubMed

    Jeannin, A; Dubois-Arber, F; Paccaud, F

    1994-11-01

    To obtain information about the prevalence of, reasons for, and adequacy of HIV testing in the general population in Switzerland in 1992. Telephone survey (n = 2800). Some 47% of the sample underwent one HIV test performed through blood donation (24%), voluntary testing (17%) or both (6%). Of the sample, 46% considered themselves well or very well informed about the HIV test. Patients reported unsystematic pre-test screening by doctors for the main HIV risks. People having been in situations of potential exposure to risk were more likely to have had the test than others. Overall, 85% of those HIV-tested had a relevant, generally risk-related reason for having it performed. HIV testing is widespread in Switzerland. Testing is mostly performed for relevant reasons. Pre-test counselling is poor and an opportunity for prevention is thus lost.

  12. Systems serology for evaluation of HIV vaccine trials.

    PubMed

    Ackerman, Margaret E; Barouch, Dan H; Alter, Galit

    2017-01-01

    The scale and scope of the global epidemic, coupled to challenges with traditional vaccine development approaches, point toward a need for novel methodologies for HIV vaccine research. While the development of vaccines able to induce broadly neutralizing antibodies remains the ultimate goal, to date, vaccines continue to fail to induce these rare humoral immune responses. Conversely, growing evidence across vaccine platforms in both non-human primates and humans points to a role for polyclonal vaccine-induced antibody responses in protection from infection. These candidate vaccines, despite employing disparate viral vectors and immunization strategies, consistently identify a role for functional or non-traditional antibody activities as correlates of immunity. However, the precise mechanism(s) of action of these "binding" antibodies, their specific characteristics, and their ability to be selectively induced and/or potentiated to result in complete protection merits parallel investigation to neutralizing antibody-based vaccine design approaches. Ultimately, while neutralizing and functional antibody-based vaccine strategies need not be mutually exclusive, defining the specific characteristics of "protective" functional antibodies may provide a target immune profile to potentially induce more robust immunity against HIV. Specifically, one approach to guide the development of functional antibody-based vaccine strategies, termed "systems serology", offers an unbiased and comprehensive approach to systematically survey humoral immune responses, capturing the array of functions and humoral response characteristics that may be induced following vaccination with high resolution. Coupled to machine learning tools, large datasets that explore the "antibody-ome" offer a means to step back from anticipated correlates and mechanisms of protection and toward a more fundamental understanding of coordinated aspects of humoral immune responses, to more globally differentiate among

  13. Posttherapeutic Cure Criteria in Chagas' Disease: Conventional Serology followed by Supplementary Serological, Parasitological, and Molecular Tests

    PubMed Central

    Silva, A. R.; Do Bem, V. A. L.; Bahia, M. T.; Martins-Filho, O. A.; Dias, J. C. P.; Albajar-Viñas, P.; Torres, R. M.; Lana, M.

    2012-01-01

    We performed a critical study of conventional serology, followed by supplementary serological, parasitological, and molecular tests, to assess the response to etiologic treatment of Chagas' disease. A group of 94 Chagas' disease patients treated with benznidazole at least 10 years earlier were evaluated from the laboratory and clinical points of view. When conventional serology (enzyme-linked immunosorbent assay [ELISA], indirect immunofluorescence [IIF], and indirect hemagglutination [IHA]) and classic criteria (consistent results with any two of the three tests) or more rigorous criteria (consistent results from the three tests) were used, 10.6% and 8.5% of patients were considered treated and cured (TC) by classic and rigorous criteria, respectively. Patients were then evaluated using supplementary (recombinant ELISA and Trypanosoma cruzi excreted-secreted antigen blotting [TESA-blot]), parasitological (hemoculture), and molecular (PCR) tests. The results of recombinant ELISA were similar to those with the rigorous criterion (three consistent test results). The TESA-blot group showed a higher percentage (21.3%) of negative results than the groups defined by either cure criterion. Hemoculture and PCR gave negative results for all treated and cured (TC) patients, regardless of the criterion used. Recombinant ELISA and TESA-blot tests showed negative results for 70% and 87.5% of the patients categorized as TC by the classic and three-test criteria, respectively. For patients with discordant conventional serology, the supplementary serological and molecular tests were the decisive factor in determining therapeutic failure. Clinical evaluation showed that 62.5% of TC patients presented with the indeterminate form of the disease. Additionally, treated patients with negative TESA-blot results should be reevaluated later with all methodologies used here to verify whether TESA-blot is a reliable way to determine early parasitological cure of Chagas' disease. PMID

  14. Smart HIV testing system.

    PubMed

    El Kateeb, Ali; Law, Peter; Chan, King

    2005-06-01

    The quick HIV testing method called "MiraWell Rapid HIV Test" uses a specialized testing kit to determine whether an individual's blood is contaminated with the HIV virus or not. When a drop of blood is placed on the center of the testing kit, a simple pattern will appear in the middle of the kit to indicate the test status, i.e., positive or negative. This HIV test should be done in a small clinic or in a lab and the test must be conducted by a trained technician. A smart HIV testing system was developed through this research to eliminate the human error that is associated with the use of the quick HIV testing kits. Also, the smart HIV system will improve the testing productivity in comparison to those achieved by the trained technicians. In this research, we have developed a cost-effective system that analyzes the image produced by the HIV kits. We have used a System-On-Chip (SOC) design approach based on the Field Programmable Gate Array (FPGA) technology and the Xilinx Virtex SOC chip in building the system's prototype. The system used a CMOS digital camera to capture the image and an FPGA chip to process the captured image and send the testing results to the display unit. The system can be used in small clinics and pharmacies and eliminates the need for trained technicians. The system has been tested successfully and 98% of the tests were correct.

  15. Comparative infectious serology testing of pre- and post-mortem blood samples from cornea donors.

    PubMed

    Wilkemeyer, I; Pruss, A; Kalus, U; Schroeter, J

    2012-08-01

    Defined serological blood tests of deceased cornea donors are required to minimize the risk of viral infections of a transplant recipient as much as possible. Haemolysis, autolysis and bacterial contamination, may produce significant changes of post-mortem blood samples, which may lead to false serological test results. Pre- and post-mortem findings from the same cornea donors of the University Tissue Bank of the Charité in the years 2004-2009 (n = 487) were retrospectively analyzed and compared. The test results from pre-mortem blood samples were defined as the reference for the post-mortem blood test. Of 487 cornea donors, there were a total of 21 cases (4.3%) with discrepancies between serological test results from pre- and post-mortem blood samples. Of these, 7 values referred to the HBsAg-testing, 3 to the anti-HBs-, 1 to the anti-HBcIgG + IgM-, 1 to the anti-HCV-, 4 to the anti-HIV 1/2- and 5 to the TPLA-findings. False negative results within post-mortem serology occurred in 4 of 487 cases (0.8%). False positive results within the post-mortem blood samples occurred at a much more frequent rate, with 17 of 487 cases (3.5%). Discrepancies between serological pre- and post-mortem blood tests occur mainly due to the use of non-validated test systems. Therefore, it seems reasonable to test pre- and post-mortem blood samples serologically, whenever possible, at the same time, regardless of the sample age. Positive results, regardless of the sample type, should always be retested with validated confirmation tests (e.g. NAT), in order to differentiate between false and true positive results.

  16. [Comparative analysis of serological tests performed in immigrants in the Lleida health area].

    PubMed

    Soler-González, Jorge; Real, Jordi; Farré, Joan; Serna, Caty; Cruz, Inés; Ruiz, Cristina; Bosch, Anna

    2013-02-01

    Evaluate the process of screening and detection of HIV, HBV, HCV and syphilis in the province of Lleida by determining the proportions of positive results in the different groups during one year. Descriptive, multicentre study of all the serological tests performed in immigrants and natives attended in 2007. Province of Lleida (Spain). 255,410 users. Age, sex, country of origin and period of residence in Spain, and the results for HIV, hepatitis B, hepatitis C and syphilis. We calculated the proportions in which a serological test had been requested, and examined the association between the rates of positive tests and the geographical area of origin, and calculated age-adjusted rates taking the age distribution of the native population as the reference. Risk of HBV was 4.6 times higher in immigrants than in natives (11.7 times in sub-Saharan Africans). The rate of positive syphilis tests was three times higher in the immigrant group. For HIV the PR was 2.3 (sub-Saharan Africans 7.4). For hepatitis C the risk was lower in immigrants than in natives (PR=0.4). Immigrants have a higher probability of testing positive in screening in hepatitis B, syphilis and HIV. The rates differ significantly according to the origin of the immigrant. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  17. Clinical performance of the Multispot HIV-1/HIV-2 rapid test to correctly differentiate HIV-2 from HIV-1 infection in screening algorithms using third and fourth generation assays and to identify cross reactivity with the HIV-1 Western Blot.

    PubMed

    Ramos, Eric M; Harb, Socorro; Dragavon, Joan; Coombs, Robert W

    2013-12-01

    An accurate and rapid serologic method to differentiate HIV-2 from HIV-1 infection is required since the confirmatory HIV-1 Western Blot (WB) may demonstrate cross-reactivity with HIV-2 antibodies. To evaluate the performance of the Bio-Rad Multispot HIV-1/HIV-2 rapid assay as a supplemental test to correctly identify HIV-2 infection and identify HIV-1 WB cross-reactivity with HIV-2 in clinical samples tested at an academic medical center. Between August 2008 and July 2012, clinical samples were screened for HIV using either 3rd- or 4th-generation HIV-1/2 antibody or combination antibody and HIV-1 p24 antigen assays, respectively. All repeatedly reactive samples were reflexed for Multispot rapid testing. Multispot HIV-2 and HIV-1 and HIV-2-reactive samples were further tested using an HIV-2 immunoblot assay and HIV-1 or HIV-2 RNA assays when possible. The HIV-1 WB was performed routinely for additional confirmation and to assess for HIV-2 antibody cross-reactivity. Of 46,061 samples screened, 890 (89.6%) of 993 repeatedly reactive samples were also Multispot-reactive: 882 for HIV-1; three for only HIV-2; and five for both HIV-1 and HIV-2. All three HIV-2-only Multispot-positives along with a single dually reactive HIV-1/2 Multispot-positive were also HIV-2 immunoblot-positive; the latter was HIV-1 RNA negative and HIV-2 RNA positive. The Multispot rapid test performed well as a supplemental test for HIV-1/2 diagnostic testing. Four new HIV-2 infections (0.45%) were identified from among 890 Multispot-reactive tests. The use of HIV-1 WB alone to confirm HIV-1/2 screening assays may underestimate the true prevalence of HIV-2 infection in the United States. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Sensitivity and Specificity of Human Immunodeficiency Virus Rapid Serologic Assays and Testing Algorithms in an Antenatal Clinic in Abidjan, Ivory Coast

    PubMed Central

    Koblavi-Dème, Stéphania; Maurice, Chantal; Yavo, Daniel; Sibailly, Toussaint S.; N′guessan, Kabran; Kamelan-Tano, Yvonne; Wiktor, Stefan Z.; Roels, Thierry H.; Chorba, Terence; Nkengasong, John N.

    2001-01-01

    To evaluate serologic testing algorithms for human immunodeficiency virus (HIV) based on a combination of rapid assays among persons with HIV-1 (non-B subtypes) infection, HIV-2 infection, and HIV-1–HIV-2 dual infections in Abidjan, Ivory Coast, a total of 1,216 sera with known HIV serologic status were used to evaluate the sensitivity and specificity of four rapid assays: Determine HIV-1/2, Capillus HIV-1/HIV-2, HIV-SPOT, and Genie II HIV-1/HIV-2. Two serum panels obtained from patients recently infected with HIV-1 subtypes B and non-B were also included. Based on sensitivity and specificity, three of the four rapid assays were evaluated prospectively in parallel (serum samples tested by two simultaneous rapid assays) and serial (serum samples tested by two consecutive rapid assays) testing algorithms. All assays were 100% sensitive, and specificities ranged from 99.4 to 100%. In the prospective evaluation, both the parallel and serial algorithms were 100% sensitive and specific. Our results suggest that rapid assays have high sensitivity and specificity and, when used in parallel or serial testing algorithms, yield results similar to those of enzyme-linked immunosorbent assay-based testing strategies. HIV serodiagnosis based on rapid assays may be a valuable alternative in implementing HIV prevention and surveillance programs in areas where sophisticated laboratories are difficult to establish. PMID:11325995

  19. Performance of routine syphilis serology in the Ethiopian cohort on HIV/AIDS

    PubMed Central

    Dorigo-Zetsma, J; Belewu, D; Meless, H; Sanders, E; Coutinho, R; Schaap, A; Wolday, D

    2004-01-01

    Objectives: To assess the performance of routine syphilis screening during 5 year follow up of Ethiopian factory workers, participating in a cohort study on HIV/AIDS. Methods: Syphilis serology test results of factory workers, who each donated at least six blood samples were evaluated. Screening in 1997–8 had been performed by the Treponema pallidum particle agglutination (TPPA) assay and in 1999–2001 by the rapid plasma reagin (RPR) test. TPPA had been followed by RPR or RPR by TPPA, in case of a positive screening result. Samples of study subjects showing inconsistent sequential TPPA and/or RPR results were retested independently by three laboratory technicians. Results: A total of 540 cohort participants (8.3% HIV positive at enrolment) donated 4376 blood samples (mean 8.3 per subject). From 93 of the 176 participants with at least one positive TPPA result during follow up, 152 samples were retested by RPR and/or TPPA. Based on the revised syphilis test results, the 540 cohort participants were classified as having no (70.5%), past (20.6%), prevalent (6.9%), or incident (2.0%) syphilis. The RPR screening test was difficult to interpret and yielded 8.2% biological false positive (BFP) RPR results, or 3.2% if weak positive results were excluded. There was no correlation between HIV infection and BFP RPR reactions. Sample mix-ups were detected in 1.2%. Conclusion: Evaluation of routine syphilis screening as performed in a long term cohort study on HIV/AIDS in Ethiopia showed difficulties encountered in syphilis screening programmes such as a high percentage of BFP RPR, inconsistencies in interpretation of the RPR test, and sample mix ups. The findings stress the need to develop a syphilis screening assay that is easy to perform and interpret and to implement quality assurance programmes. PMID:15054167

  20. Predictors of Serological Cure and Serofast State After Treatment in HIV-Negative Persons With Early Syphilis

    PubMed Central

    Seña, Arlene C.; Wolff, Mark; Martin, David H.; Behets, Frieda; Van Damme, Kathleen; Leone, Peter; Langley, Carol; McNeil, Linda; Hook, Edward W.

    2011-01-01

    Background. Syphilis management requires serological monitoring after therapy. We compared factors associated with serological response after treatment of early (ie, primary, secondary, or early latent) syphilis. Methods. We performed secondary analyses of data from a prospective, randomized syphilis trial conducted in the United States and Madagascar. Human immunodeficiency virus (HIV)–negative participants aged ≥18 years with early syphilis were enrolled from 2000–2009. Serological testing was performed at baseline and at 3 and 6 months after treatment. At 6 months, serological cure was defined as a negative rapid plasma reagin (RPR) test or a ≥4-fold decreased titer, and serofast status was defined as a ≤2-fold decreased titer or persistent titers that did not meet criteria for treatment failure. Results. Data were available from 465 participants, of whom 369 (79%) achieved serological cure and 96 (21%) were serofast. In bivariate analysis, serological cure was associated with younger age, fewer sex partners, higher baseline RPR titers, and earlier syphilis stage (P ≤ .008). There was a less significant association with Jarisch-Herxheimer reaction after treatment (P = .08). Multivariate analysis revealed interactions between log-transformed baseline titer with syphilis stage, in which the likelihood of cure was associated with increased titers among participants with primary syphilis (adjusted odds ratio [AOR] for 1 unit change in log2 titer, 1.83; 95% confidence interval [CI], 1.25–2.70), secondary syphilis (AOR, 3.15; 95% CI, 2.14–4.65), and early latent syphilis (AOR, 1.86; 95% CI, 1.44–2.40). Conclusions. Serological cure at 6 months after early syphilis treatment is associated with age, number of sex partners, Jarisch-Herxheimer reaction, and an interaction between syphilis stage and baseline RPR titer. PMID:21998287

  1. Get Tested for HIV

    MedlinePlus

    ... the Affordable Care Act , the health care reform law passed in 2010, insurance plans must cover HIV testing. HIV counseling is covered for women who are sexually active. Talk to your insurance company to find out more. To learn about other ...

  2. Clinical Utility of Serologic Testing for Celiac Disease in Ontario

    PubMed Central

    2010-01-01

    Executive Summary Objective of Analysis The objective of this evidence-based evaluation is to assess the accuracy of serologic tests in the diagnosis of celiac disease in subjects with symptoms consistent with this disease. Furthermore the impact of these tests in the diagnostic pathway of the disease and decision making was also evaluated. Celiac Disease Celiac disease is an autoimmune disease that develops in genetically predisposed individuals. The immunological response is triggered by ingestion of gluten, a protein that is present in wheat, rye, and barley. The treatment consists of strict lifelong adherence to a gluten-free diet (GFD). Patients with celiac disease may present with a myriad of symptoms such as diarrhea, abdominal pain, weight loss, iron deficiency anemia, dermatitis herpetiformis, among others. Serologic Testing in the Diagnosis Celiac Disease There are a number of serologic tests used in the diagnosis of celiac disease. Anti-gliadin antibody (AGA) Anti-endomysial antibody (EMA) Anti-tissue transglutaminase antibody (tTG) Anti-deamidated gliadin peptides antibodies (DGP) Serologic tests are automated with the exception of the EMA test, which is more time-consuming and operator-dependent than the other tests. For each serologic test, both immunoglobulin A (IgA) or G (IgG) can be measured, however, IgA measurement is the standard antibody measured in celiac disease. Diagnosis of Celiac Disease According to celiac disease guidelines, the diagnosis of celiac disease is established by small bowel biopsy. Serologic tests are used to initially detect and to support the diagnosis of celiac disease. A small bowel biopsy is indicated in individuals with a positive serologic test. In some cases an endoscopy and small bowel biopsy may be required even with a negative serologic test. The diagnosis of celiac disease must be performed on a gluten-containing diet since the small intestine abnormalities and the serologic antibody levels may resolve or improve

  3. HIV Testing in the United States

    MedlinePlus

    ... HIV/AIDS HIV Testing in the United States HIV Testing in the United States Jun 23, 2017 ... States or for refugees. 27 Insurance Coverage of HIV Testing HIV testing that is “medically necessary” – recommended ...

  4. Evaluation of Commercially Available Serologic Diagnostic Tests for Chikungunya Virus

    PubMed Central

    Flusin, Olivier; Panella, Amanda; Tenebray, Bernard; Lanciotti, Robert; Leparc-Goffart, Isabelle

    2014-01-01

    Chikungunya virus (CHIKV) is present or emerging in dengue virus–endemic areas. Infections caused by these viruses share some common signs/symptoms, but prognosis, patient care, and persistent symptoms differ. Thus, accurate diagnostic methods are essential for differentiating the infections. We evaluated 4 CHIKV serologic diagnostic tests, 2 of which showed poor sensitivity and specificity. PMID:25418184

  5. Targeted testing for acute HIV infection in North Carolina.

    PubMed

    Miller, William C; Leone, Peter A; McCoy, Sandra; Nguyen, Trang Q; Williams, Delbert E; Pilcher, Christopher D

    2009-04-27

    Persons with acute HIV infection contribute disproportionately to HIV transmission. The identification of these persons is a critical public health challenge. We developed targeted approaches for detecting HIV RNA in persons with negative serological tests. Persons undergoing publicly funded HIV testing in North Carolina between October 2002 and April 2005 were included in this cross-sectional study. We used logistic regression to develop targeted testing approaches. We also assessed simple approaches based on clinic type and geography. Algorithm development used persons with recent HIV infection, determined by a detuned enzyme-linked immunosorbent assay. Validation used persons with acute HIV infection, identified with an HIV RNA pooling procedure. Among 215 528 eligible persons, 232 persons had recent HIV infection and 44 had acute HIV infection. A combination of five indicators (testing site, sexual preference, sex with a person with HIV infection, county HIV incidence, and race) identified 92% of recent infections when testing 50% of the population. In validation among persons with acute HIV infection, this indicator combination had sensitivities of 98% in years 1 and 2 and 88% in year 3. A simple combination of testing site and county performed nearly as well [development (recent infections): sensitivity = 95%; validation (acute infections): sensitivity = 86% in years 1 and 2; 81% in year 3; cut-off established for testing 50% of population.] Acute HIV infection can be identified accurately using targeted testing. Simple approaches for identifying the types of clinics and geographical areas where infections are concentrated may be logistically feasible and cost-efficient.

  6. Serological Response to Treatment of Syphilis with Doxycycline Compared with Penicillin in HIV-infected Individuals.

    PubMed

    Salado-Rasmussen, Kirsten; Hoffmann, Steen; Cowan, Susan; Jensen, Jørgen Skov; Benfield, Thomas; Gerstoft, Jan; Katzenstein, Terese Lea

    2016-08-23

    Serological response to treatment of syphilis with orally administered doxycycline or intramuscularly administered penicillin was assessed in patients with concurrent HIV. All HIV-infected individuals diagnosed with syphilis attending 3 hospitals in Copenhagen, Denmark were included. Odds ratios (ORs) with 95% confidence intervals (CI) associated with serological outcome were modelled using propensity-score-adjusted logistic regression analysis. In total, 202 cases were treated with doxycycline or intramuscular penicillin. At 12 months, serological failure was observed in 12 cases (15%) treated with doxycycline and in 8 cases (17%) treated with penicillin (OR 0.78 (95% CI 0.16-3.88), p = 0.76). The serological cure rate at 12 months was highest in patients with primary syphilis (100%), followed by patients with secondary (89%), early latent (71%) and late latent (67%) syphilis (p = 0.006). In conclusion, this study provides evidence for the use of doxycycline as a treatment option when treating a HIV-infected population for syphilis.

  7. Evaluation of Eight Serological Tests for Diagnosis of Imported Schistosomiasis

    PubMed Central

    Dittrich, Sabine; Bäumer, Britta

    2012-01-01

    The diagnosis of schistosomiasis in individuals from countries where the disease is not endemic is challenging, and few data are available on the accuracy of serological diagnosis in those patients. We evaluated the performance of eight serological assays, including four commercial kits, in the diagnosis of imported schistosomiasis in individuals from areas where the disease is not endemic, including six enzyme-linked immunosorbent assays using three different antigens, an indirect hemagglutination assay, and an indirect immunofluorescent-antibody test. To analyze the assays, we used a total of 141 serum samples, with 121 derived from patients with various parasitic infections (among which were 37 cases of schistosomiasis) and 20 taken from healthy volunteers. The sensitivity values for detection of schistosomiasis cases ranged from 41% to 78% and were higher for Schistosoma mansoni than for S. haematobium infections. Specificity values ranged from 76% to 100%; false-positive results were most frequent for samples from patients with cestode infections. By combining two or more tests, sensitivity improved markedly and specificity decreased only moderately. Serological tests are useful instruments for diagnosing imported schistosomiasis in countries where the disease is not endemic, but due to limitations in test sensitivities, we recommend the use of two or more assays in parallel. PMID:22441394

  8. Serologic Testing for Salmonella Infections in Poultry Flocks: Limitations and Opportunities

    USDA-ARS?s Scientific Manuscript database

    Diverse serologic methods have been developed and applied to successfully detect Salmonella infections in poultry with both sensitivity and consistency. However, the field application of serology has been limited by several inherent characteristics of antibody detection tests: (1) infections without...

  9. An appraisal of thoracic procedures performed in patients with HIV-positive serology.

    PubMed

    Canver, C C

    1995-08-01

    Patients who have contracted the human immunodeficiency virus (HIV) often require a diagnostic or therapeutic thoracic procedure. To determine the clinical benefits of a noncardiac pulmonary intervention in the treatment of HIV-positive individuals, 82 patients with HIV-positive serology who underwent a thoracic procedure for illnesses related to acquired immunodeficiency syndrome (AIDS) between 1987 and 1990 were reviewed. Pneumocystis carinii pneumonia was the most common opportunistic infection and was the initial manifestation for establishing the HIV-positive serology in 54 patients (66%). Fiberoptic bronchoscopy was performed in 74 patients (90%), closed tube thoracostomy in 9 (11%), thoracentesis in 3 (4%), thoracostomy and lung resection in 2 (2.4%), pericardial window in 1 (1.2%), and tracheostomy in 1 (1.2%). The operation was useful in 46 patients (56%) and improved the clinical short-term outcome of 53 patients (64%). Nonfatal complications occurred in only two patients (2.4%). There were no deaths directly caused by the thoracic procedure within the first 30 days. However, overall 8 patients (10%ZZ) succumbed to infectious complications of AIDS. We conclude that thoracic procedures directed toward pulmonary opportunistic infections and their complications in HIV-positive patients are beneficial and may offer an improved short-term outcome.

  10. A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis

    PubMed Central

    Steingart, Karen R; Henry, Megan; Laal, Suman; Hopewell, Philip C; Ramsay, Andrew; Menzies, Dick; Cunningham, Jane; Weldingh, Karin; Pai, Madhukar

    2007-01-01

    Conventional diagnostic tests for tuberculosis have several limitations and are often unhelpful in establishing the diagnosis of extrapulmonary tuberculosis. Although commercial serological antibody based tests are available, their usefulness in the diagnosis of extrapulmonary tuberculosis is unknown. A systematic review was conducted to assess the accuracy of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis. In a comprehensive search, 21 studies that reported data on sensitivity and specificity for extrapulmonary tuberculosis were identified. These studies evaluated seven different commercial tests, with Anda‐TB IgG accounting for 48% of the studies. The results showed that (1) all commercial tests provided highly variable estimates of sensitivity (range 0.00–1.00) and specificity (range 0.59–1.00) for all extrapulmonary sites combined; (2) the Anda‐TB IgG kit showed highly variable sensitivity (range 0.26–1.00) and specificity (range 0.59–1.00) for all extrapulmonary sites combined; (3) for all tests combined, sensitivity estimates for both lymph node tuberculosis (range 0.23–1.00) and pleural tuberculosis (range 0.26–0.59) were poor and inconsistent; and (4) there were no data to determine the accuracy of the tests in children or in patients with HIV infection, the two groups for which the test would be most useful. At present, commercial antibody detection tests for extrapulmonary tuberculosis have no role in clinical care or case detection. PMID:17989270

  11. A systematic review of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis

    PubMed Central

    Steingart, Karen R; Henry, Megan; Laal, Suman; Hopewell, Philip C; Ramsay, Andrew; Menzies, Dick; Cunningham, Jane; Weldingh, Karin; Pai, Madhukar

    2007-01-01

    Conventional diagnostic tests for tuberculosis have several limitations and are often unhelpful in establishing the diagnosis of extrapulmonary tuberculosis. Although commercial serological antibody based tests are available, their usefulness in the diagnosis of extrapulmonary tuberculosis is unknown. A systematic review was conducted to assess the accuracy of commercial serological antibody detection tests for the diagnosis of extrapulmonary tuberculosis. In a comprehensive search, 21 studies that reported data on sensitivity and specificity for extrapulmonary tuberculosis were identified. These studies evaluated seven different commercial tests, with Anda‐TB IgG accounting for 48% of the studies. The results showed that (1) all commercial tests provided highly variable estimates of sensitivity (range 0.00–1.00) and specificity (range 0.59–1.00) for all extrapulmonary sites combined; (2) the Anda‐TB IgG kit showed highly variable sensitivity (range 0.26–1.00) and specificity (range 0.59–1.00) for all extrapulmonary sites combined; (3) for all tests combined, sensitivity estimates for both lymph node tuberculosis (range 0.23–1.00) and pleural tuberculosis (range 0.26–0.59) were poor and inconsistent; and (4) there were no data to determine the accuracy of the tests in children or in patients with HIV infection, the two groups for which the test would be most useful. At present, commercial antibody detection tests for extrapulmonary tuberculosis have no role in clinical care or case detection. PMID:17675320

  12. Establishment of serological test to detect antibody against ferret coronavirus

    PubMed Central

    MINAMI, Shohei; TERADA, Yutaka; SHIMODA, Hiroshi; TAKIZAWA, Masaki; ONUMA, Mamoru; OTA, Akihiko; OTA, Yuichi; AKABANE, Yoshihito; TAMUKAI, Kenichi; WATANABE, Keiichiro; NAGANUMA, Yumiko; KANAGAWA, Eiichi; NAKAMURA, Kaneichi; OHASHI, Masanari; TAKAMI, Yoshinori; MIWA, Yasutsugu; TANOUE, Tomoaki; OHWAKI, Masao; OHTA, Jouji; UNE, Yumi; MAEDA, Ken

    2016-01-01

    Since there is no available serological methods to detect antibodies to ferret coronavirus (FRCoV), an enzyme-linked immunosorbent assay (ELISA) using recombinant partial nucleocapsid (N) proteins of the ferret coronavirus (FRCoV) Yamaguchi-1 strain was developed to establish a serological method for detection of FRCoV infection. Many serum samples collected from ferrets recognized both a.a. 1–179 and a.a. 180–374 of the N protein, but two serum samples did not a.a. 180–374 of the N protein. This different reactivity was also confirmed by immunoblot analysis using the serum from the ferret.Therefore, the a.a. 1–179 of the N protein was used as an ELISA antigen. Serological test was carried out using sera or plasma of ferrets in Japan. Surprisingly, 89% ferrets in Japan had been infected with FRCoV. These results indicated that our established ELISA using a.a. 1–179 of the N protein is useful for detection of antibody to FRCoV for diagnosis and seroepidemiology of FRCoV infection. PMID:26935842

  13. Establishment of serological test to detect antibody against ferret coronavirus.

    PubMed

    Minami, Shohei; Terada, Yutaka; Shimoda, Hiroshi; Takizawa, Masaki; Onuma, Mamoru; Ota, Akihiko; Ota, Yuichi; Akabane, Yoshihito; Tamukai, Kenichi; Watanabe, Keiichiro; Naganuma, Yumiko; Kanagawa, Eiichi; Nakamura, Kaneichi; Ohashi, Masanari; Takami, Yoshinori; Miwa, Yasutsugu; Tanoue, Tomoaki; Ohwaki, Masao; Ohta, Jouji; Une, Yumi; Maeda, Ken

    2016-07-01

    Since there is no available serological methods to detect antibodies to ferret coronavirus (FRCoV), an enzyme-linked immunosorbent assay (ELISA) using recombinant partial nucleocapsid (N) proteins of the ferret coronavirus (FRCoV) Yamaguchi-1 strain was developed to establish a serological method for detection of FRCoV infection. Many serum samples collected from ferrets recognized both a.a. 1-179 and a.a. 180-374 of the N protein, but two serum samples did not a.a. 180-374 of the N protein. This different reactivity was also confirmed by immunoblot analysis using the serum from the ferret.Therefore, the a.a. 1-179 of the N protein was used as an ELISA antigen. Serological test was carried out using sera or plasma of ferrets in Japan. Surprisingly, 89% ferrets in Japan had been infected with FRCoV. These results indicated that our established ELISA using a.a. 1-179 of the N protein is useful for detection of antibody to FRCoV for diagnosis and seroepidemiology of FRCoV infection.

  14. Evaluation of four serological tests for bovine paratuberculosis.

    PubMed Central

    Sockett, D C; Conrad, T A; Thomas, C B; Collins, M T

    1992-01-01

    The standard complement fixation (CF) test, a commercial agarose gel immunodiffusion (AGID) test (ImmuCell Corporation, Portland, Maine), and two commercial enzyme-linked immunosorbent assays (ELISAs; Allied Laboratories, Glenwood Springs, Colo. [Allied ELISA], and the CSL, Limited, [Parkville, Victoria, Australia] enzyme immunoassay [CSL ELISA]) were evaluated by using sera from the Repository for Paratuberculosis Specimens. The case definition of subclinical bovine paratuberculosis was isolation of Mycobacterium paratuberculosis from fecal samples or internal organs of dairy cattle without diarrhea or weight loss. Animals designated as free of the disease originated exclusively from certified paratuberculosis-free herds in Wisconsin. None of the cattle evaluated had been vaccinated for paratuberculosis. Among 177 M. paratuberculosis-infected cattle, the CF test, the AGID test, the Allied ELISA, and the CSL ELISA had test sensitivities of 38.4, 26.6, 58.8, and 43.4%, respectively, and specificities of 99.0, 100.0, 95.4, and 99.0%, respectively. Only 108 of the infected cattle were confirmed by culture or by a commercial DNA probe (IDEXX Corporation, Portland, Maine) to be shedding the organism in fecal samples at the time of serological testing. Among the 108 M. paratuberculosis fecal shedders, the CF test, the AGID test, the Allied ELISA, and the CSL ELISA were positive for 54.6, 40.7, 65.7, and 56.5% of the cows, respectively; and among the 69 cows that were nonshedders, the tests were positive for 14.5, 4.3, 47.8, and 24.6% of the cows, respectively. There was a significant difference (P < 0.05) in the rate of positive test results for all four tests between these two groups of animals. The CF test performed well when it was compared with the other serological tests if a titer of >/- 1.8 was classified as a positive test result. PMID:1583110

  15. Diagnostic performance of serological tests for swine brucellosis in the presence of false positive serological reactions.

    PubMed

    Dieste-Pérez, L; Blasco, J M; de Miguel, M J; Moriyón, I; Muñoz, P M

    2015-04-01

    Swine brucellosis caused by Brucella suis biovar 2 is an emerging disease in Europe. Currently used diagnostic tests for swine brucellosis detect antibodies to the O-polysaccharide (O-PS) of Brucella smooth lipopolysaccharide (S-LPS) but their specificity is compromised by false-positive serological reactions (FPSRs) when bacteria carrying cross-reacting O-PS infect pigs. FPSRs occur throughout Europe, and the only tool available for a specific B. suis diagnosis is the intradermal test with Brucella protein extracts free of O-PS or S-LPS. Using sera of 162 sows naturally infected by B. suis biovar 2, 406 brucellosis-free sows, and 218 pigs of brucellosis-free farms affected by FPSR, we assessed the diagnostic performance of an indirect ELISA with rough LPS (thus devoid of O-PS) and of gel immunodiffusion, counterimmunoelectrophoresis, latex agglutination and indirect ELISA with O-PS free proteins in comparison with several S-LPS tests (Rose Bengal, complement fixation, gel immunodiffusion and indirect ELISA). When adjusted to 100% specificity, the sensitivity of the rough LPS ELISA was very low (30%), and adoption of other cut-offs resulted in poor specificity/sensitivity ratios. Although their specificity was 100%, the sensitivity of protein tests (ELISA, latex agglutination, counterimmunoelectrophoresis, and gel immunodiffusion) was only moderate (45, 58, 61 and 63%, respectively). Among S-LPS tests, gel immunodiffusion was the only test showing acceptable sensitivity/specificity (68 and 100%, respectively). Despite these shortcomings, and when the purpose is to screen out FPSR at herd level, gel immunodiffusion tests may offer a technically simple and practical alternative to intradermal testing.

  16. Clinical validation of a novel diagnostic HIV-2 total nucleic acid qualitative assay using the Abbott m2000 platform: Implications for complementary HIV-2 nucleic acid testing for the CDC 4th generation HIV diagnostic testing algorithm.

    PubMed

    Chang, Ming; Wong, Audrey J S; Raugi, Dana N; Smith, Robert A; Seilie, Annette M; Ortega, Jose P; Bogusz, Kyle M; Sall, Fatima; Ba, Selly; Seydi, Moussa; Gottlieb, Geoffrey S; Coombs, Robert W

    2017-01-01

    The 2014 CDC 4th generation HIV screening algorithm includes an orthogonal immunoassay to confirm and discriminate HIV-1 and HIV-2 antibodies. Additional nucleic acid testing (NAT) is recommended to resolve indeterminate or undifferentiated HIV seroreactivity. HIV-2 NAT requires a second-line assay to detect HIV-2 total nucleic acid (TNA) in patients' blood cells, as a third of untreated patients have undetectable plasma HIV-2 RNA. To validate a qualitative HIV-2 TNA assay using peripheral blood mononuclear cells (PBMC) from HIV-2-infected Senegalese study participants. We evaluated the assay precision, sensitivity, specificity, and diagnostic performance of an HIV-2 TNA assay. Matched plasma and PBMC samples were collected from 25 HIV-1, 30 HIV-2, 8 HIV-1/-2 dual-seropositive and 25 HIV seronegative individuals. Diagnostic performance was evaluated by comparing the outcome of the TNA assay to the results obtained by the 4th generation HIV screening and confirmatory immunoassays. All PBMC from 30 HIV-2 seropositive participants tested positive for HIV-2 TNA including 23 patients with undetectable plasma RNA. Of the 30 matched plasma specimens, one was HIV non-reactive. Samples from 50 non-HIV-2 infected individuals were confirmed as non-reactive for HIV-2 Ab and negative for HIV-2 TNA. The agreement between HIV-2 TNA and the combined immunoassay results was 98.8% (79/80). Furthermore, HIV-2 TNA was detected in 7 of 8 PBMC specimens from HIV-1/HIV-2 dual-seropositive participants. Our TNA assay detected HIV-2 DNA/RNA in PBMC from serologically HIV-2 reactive, HIV indeterminate or HIV undifferentiated individuals with undetectable plasma RNA, and is suitable for confirming HIV-2 infection in the HIV testing algorithm. Copyright © 2016 Elsevier B.V. All rights reserved.

  17. [The detection of antibodies against HIV-1 24-kd protein. A clinico-serological correlation].

    PubMed

    Díaz Torres, H; Silva Cabrera, E; Rodríguez García, O; Bárcenas Moses, J; Lubián Caballero, A L

    1996-01-01

    The presence of antibodies against the HIV protein of 24 kd was studies by the parallel use of the DAVIH BLOT western blot and of the DAVIH AC P24 ELISA in serum samples from 176 patients at different HIV-1 infection stages. The results were correlated with the clinical classification of the patient at the moment of taking the sample and with the further evolution during 6 months. 57% of the patients with opportunistic minor infections and 96% of AIDS patients had low antibodies titres. Dead patients showed no reactivity or presented very low titres in samples taken before dying. Different titrations were observed in serum groups with an apparently uniform reactivity in the western blot. The results show and adequate clinical and serological correlation. Therefore, the DAVIH AC P24 ELISA could be useful in the clinical follow-up of HIV-1 infected persons.

  18. [Serologic cross-reactions to Leishmania infantum using indirect immunofluorescence in HIV+ and HIV- patients with active tuberculosis].

    PubMed

    López-Vélez, R; Turientes, M C; Gómez-Mampaso, E

    1998-03-01

    Clinical presentation of disseminated tuberculosis and visceral leishmaniosis can be very similar, mainly in those infected with HIV, being serology a useful tool in making a differential diagnosis. Cross-reactions of IFAT serodiagnosis of visceral leishmaniosis with other diseases are well known, but few data is available with tuberculosis. Detection of serum antibodies against Leishmania, using a commercial IFAT kit, was attempted in sera of 51 patients with active pulmonar and/or extrapulmonar tuberculosis (25 HIV+ and 26 HIV-). Overall cross-reactions was found in 19.6% patients without significative differences in between 2 groups, but differences in positive serum titres was observed: one at 1/256, three at 1/160, and one at 1/80 dilution, in the HIV+ group, whereas all 5 patients in HIV- group cross-reacted at 1/80 dilution. Recognition of specific leishmanial antigenic bands by serum antibodies of patients with tuberculosis were not clearly defined by Western-blot. IFAT technique for leishmaniosis cross-react in 20% of patients with tuberculosis.

  19. HIV testing, staging, and evaluation.

    PubMed

    Rodriguez, Carla V; Horberg, Michael A

    2014-09-01

    HIV testing and incidence are stable, but trends for certain populations are concerning. Primary prevention must be reinvigorated and target vulnerable populations. Science and policy have progressed to improve the accuracy, speed, privacy, and affordability of HIV testing. More potent and much better tolerated HIV treatments and a multidisciplinary approach to care have increased adherence and viral suppression. Changes to health care law in the United States seek to expand the affordability and access of improved HIV diagnostics and treatment. Continued challenges include improving long-term outcomes in people on lifetime regimens, reducing comorbidities associated with those regimens, and preventing further transmission. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Interpretation and clinical correlation of serological tests in paracoccidioidomycosis.

    PubMed

    Do Valle, A C; Costa, R L; Fialho Monteiro, P C; Von Helder, J; Muniz, M M; Zancopé-Oliveira, R M

    2001-08-01

    In order to correlate the findings of two serological tests, double immunodiffusion (IDD) and immunoblotting (IB), with the clinical diagnosis and follow-up of paracoccidioidomycosis (PCM), 325 serum samples from PCM patients were tested at the beginning of specific therapy and after its completion. Group I included 245 PCM patients at the onset of symptoms without treatment. In 221 cases (90.2%) the IDD showed positive reactions and in 24 (9.8%) the results were negative. Of the 24 IDD negative samples, 23 were investigated by IB and were positive. Group II included 80 PCM patients under follow-up after treatment. There were four cases of relapse in which the IDD and IB tests were positive (100%). Among the 76 cases with inactive mycotic infection, the IDD was negative in 71.2% and positive in 28.8%; the IB was positive in all cases (100%). The control group (Group III) included 27 samples from patients with other mycoses, tuberculosis and from healthy individuals. All showed negative IDD tests but positive reactions with IB, which could be abolished by serum dilutions without altering the PCM reactivity. Therefore, the utilization of the IB, an immunoenzymatic method for the diagnosis of PCM, raised the sensitivity to 100%.

  1. The importance of serological tests implementation in disseminated candidiasis diagnose.

    PubMed

    Gegić, Merima; Numanović, Fatima; Delibegović, Zineta; Tihić, Nijaz; Nurkić, Mahmut; Hukić, Mirsada

    2013-03-01

    Candidiasis is defined as an infection or disease caused by a fungus of the genus Candida. Rate of disseminated candidiasis increases with the growth of the number of immunocompromised patients. In the the last few decades the incidence of disseminated candidiasis is in growth as well as the mortality rate. The aim of this survey is to show the importance of serological tests implementation in disseminated candidiasis diagnose. This is a prospective study involving 60 patients with malign diseases with and without clinical signs of disseminated candidiasis and 30 healthy people who represent the control group. Apart from hemoculture, detection of circulating mannan antigen and adequate antibodies of Candida species applying comercial ELISA test was determined in each patient. This survey deals with relevant factors causing disseminated candidiasis. This survey showed that the group of patients with clinical signs of disseminated candidiasis had more patients with positive hemoculture to Candida species, then the group of patients without clinical signs of disseminated candidiasis. The number of patients being examined and positive to antigens and antibodies was higher (p < 0.01) in the group of patients with clinical signs of disseminated candidiasis (7/30; 23.3%), then in the group of patients without clinical signs of disseminated candidiasis (0/30; 0%): Average value of titra antigen was statistically higher (p < 0.001) in patients with Candida spp. positive hemocultures rather then in patients with Candida spp. negative hemocultures. In the group of patients with clinical signs of disseminated candidiasis 6/30 (20%) of patients had Candida spp.positive hemocultures while in the group of patients without clinical signs of disseminated candidiasis 1/30 (3.3%) of patients had Candida spp. positive hemocultures, which was considerably higher (p < 0.05). Correlation of results of hemoculture and mannan antigens and antibodies in patients with disseminated

  2. HIV Testing among Detained Youth

    ERIC Educational Resources Information Center

    Voisin, Dexter R.; Salazar, Laura F.; Crosby, Richard; DiClemente, Ralph J.; Yarber, William L.; Staples-Horne, Michelle

    2004-01-01

    Published reports have not investigated the issue of voluntary HIV testing among detained youth, a population disproportionately infected with HIV compared to other adolescent groups. Data were collected from 467 sexually active detained adolescents in Georgia on demographic, environmental, and drug and sexual history variables, to explore…

  3. HIV Testing among Detained Youth

    ERIC Educational Resources Information Center

    Voisin, Dexter R.; Salazar, Laura F.; Crosby, Richard; DiClemente, Ralph J.; Yarber, William L.; Staples-Horne, Michelle

    2004-01-01

    Published reports have not investigated the issue of voluntary HIV testing among detained youth, a population disproportionately infected with HIV compared to other adolescent groups. Data were collected from 467 sexually active detained adolescents in Georgia on demographic, environmental, and drug and sexual history variables, to explore…

  4. Serological diagnosis of human immuno-deficiency virus in Burkina Faso: reliable, practical strategies using less expensive commercial test kits.

    PubMed Central

    Meda, N.; Gautier-Charpentier, L.; Soudré, R. B.; Dahourou, H.; Ouedraogo-Traoré, R.; Ouangré, A.; Bambara, A.; Kpozehouen, A.; Sanou, H.; Valéa, D.; Ky, F.; Cartoux, M.; Barin, F.; Van de Perre, P.

    1999-01-01

    Reported are the results of a cross-sectional survey in Burkina Faso to identify reliable, practical strategies for the serological diagnosis of HIV-1 and/or HIV-2 infections, using less-expensive commercial test kits in various combinations, as an alternative to the conventional Western blot (WB) test, which costs US$ 60. Serum samples, collected from blood donors, patients with acquired immunodeficiency syndrome (AIDS) and pregnant women, were tested between December 1995 and January 1997. Twelve commercial test kits were available: five Mixt enzyme-linked immunosorbent assays (ELISA), three Mixt rapid tests, and four additional tests including monospecific HIV-1 and HIV-2 ELISA. The reference strategy utilized a combination of one ELISA or one rapid test with WB, and was conducted following WHO criteria. A total of 768 serum samples were tested; 35 were indeterminate and excluded from the analysis. Seroprevalence of HIV in the remaining 733 sera was found to be 37.5% (95% confidence interval: 34.0-41.1). All the ELISA tests showed 100% sensitivity, but their specificities ranged from 81.4% to 100%. GLA (Genelavia Mixt) had the highest positive delta value, while ICE HIV-1.0.2 (ICE) produced the most distinct negative results. Among the rapid tests, COM (CombAIDS-RS) achieved 100% sensitivity and SPO (HIV Spot) 100% specificity. Various combinations of commercial tests, according to recommended WHO strategies I, II, III, gave excellent results when ICE was included in the sequence. The best combination of tests for strategy II, which achieved 100% sensitivity and specificity, was to use ICE and COM, the cost of which was US$ 2.10, compared with US$ 55.60 for the corresponding conventional strategy. For strategy III, the best combination, which achieved 100% sensitivity and specificity, was to use ICE, ZYG (Enzygnost Anti HIV-1/HIV-2 Plus) and COM, the cost of which was US$ 2.90 (19.2 times lower than the corresponding strategy requiring WB). No rapid test

  5. Serological Immunity to Adenovirus serotype 5 is not Associated with Risk of HIV Infection: a Case-control Study

    PubMed Central

    Curlin, Marcel E.; Cassis-Ghavami, Farah; Magaret, Amalia; Spies, Greg; Duerr, Ann; Celum, Connie; Sanchez, Jorge; Margolick, Joseph B.; Detels, Roger; McElrath, M. Juliana; Corey, Lawrence

    2011-01-01

    Background Adenoviruses are among the most promising vectors for the development of an HIV vaccine. The results of the phase IIB study of the adenovirus serotype 5-based Merck Trivalent HIV vaccine have raised the concern that serological immunity to Ad5 could be linked to HIV acquisition risk in high-risk individuals. We examined the association between adenovirus serostatus and the rate of incident HIV infection in populations at elevated risk of HIV acquisition. Methods We performed a nested case-control study of Ad5 serostatus among 299 HIV-infected and 590 matched HIV-uninfected persons participating in MACS and in HPTN 039, a study of HSV-2 suppression among adults in the U.S., South America and Africa. Appropriate HIV cases and controls were identified in each cohort, and Ad5 neutralizing antibody titers were compared in these two groups. Results In MACS and HPTN 039, the relative risks of incident HIV infection among Ad5 seropositive vs. Ad5 seronegative individuals were 1.1 (95% CI 0.8–1.5, p = 0.57) and 1.0 (95% CI 0.4 – 2.3, p = 0.99) respectively. HIV-1 acquisition rates did not vary significantly by Ad5 neutralizing antibody titer. Conclusions The presence of Ad5 neutralizing antibodies is not linked to the risk of HIV acquisition among populations at elevated risk of HIV infection. PMID:21150554

  6. Prospective study of serologic tests for lyme disease.

    PubMed

    Steere, Allen C; McHugh, Gail; Damle, Nitin; Sikand, Vijay K

    2008-07-15

    Tests to determine serum antibody levels-the 2-tier sonicate immunoglobulin M (IgM) and immunoglobulin G (IgG) enzyme-linked immunosorbent assay (ELISA) and Western blot method or the IgG of the variable major protein-like sequence-expressed (VlsE) sixth invariant region (C6) peptide ELISA method-are the major tests available for support of the diagnosis of Lyme disease. However, these tests have not been assessed prospectively. We used these tests prospectively to determine serologic responses in 134 patients with various manifestations of Lyme disease, 89 patients with other illnesses (with or without a history of Lyme disease), and 136 healthy subjects from areas of endemicity and areas in which the infection was not endemic. With 2-tier tests and the C6 peptide ELISA, only approximately one-third of 76 patients with erythema migrans had results that were positive for IgM or IgG seroreactivity with Borrelia burgdorferi in acute-phase samples. During convalescence, 3-4 weeks later, almost two-thirds of patients had seroreactivity with the spirochete B. burgdorferi. The frequencies of seroreactivity were significantly greater among patients with spirochetal dissemination than they were among those who lacked evidence of disseminated disease. Of the 44 patients with Lyme disease who had neurologic, heart, or joint involvement, all had positive C6 peptide ELISA results, 42 had IgG responses with 2-tier tests, and 2 patients with facial palsy had only IgM responses. However, among the control groups, the IgG Western blot was slightly more specific than the C6 peptide ELISA. The differences between the 2 test systems (2-tier testing and C6 peptide ELISA) with respect to sensitivity and specificity were not statistically significant. Except in patients with erythema migrans, both test systems were sensitive for support of the diagnosis of Lyme disease. However, with current methods, 2-tier testing was associated with slightly better specificity.

  7. 21 CFR 866.3390 - Neisseria spp. direct serological test reagents.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Neisseria spp. direct serological test reagents. 866.3390 Section 866.3390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Serological Reagents § 866.3390...

  8. 21 CFR 866.3390 - Neisseria spp. direct serological test reagents.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Neisseria spp. direct serological test reagents. 866.3390 Section 866.3390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Serological Reagents § 866.3390...

  9. Epstein-Barr virus and human immunodeficiency virus serological responses and viral burdens in HIV-infected patients treated with HAART

    NASA Technical Reports Server (NTRS)

    O'Sullivan, Cathal E.; Peng, RongSheng; Cole, Kelly Stefano; Montelaro, Ronald C.; Sturgeon, Timothy; Jenson, Hal B.; Ling, Paul D.; Butel, J. S. (Principal Investigator)

    2002-01-01

    Epstein-Barr virus (EBV) associated non-Hodgkin lymphoma is recognized as a complication of human immunodeficiency virus (HIV) infection. Little is known regarding the influence of highly active antiretroviral therapy (HAART) on the biology of EBV in this population. To characterize the EBV- and HIV-specific serological responses together with EBV DNA levels in a cohort of HIV-infected adults treated with HAART, a study was conducted to compare EBV and HIV serologies and EBV DNA copy number (DNAemia) over a 12-month period after the commencement of HAART. All patients were seropositive for EBV at baseline. Approximately 50% of patients had detectable EBV DNA at baseline, and 27/30 had detectable EBV DNA at some point over the follow-up period of 1 year. Changes in EBV DNA copy number over time for any individual were unpredictable. Significant increases in the levels of Epstein-Barr nuclear antigen (EBNA) and Epstein-Barr early antigen (EA) antibodies were demonstrated in the 17 patients who had a good response to HAART. Of 29 patients with paired samples tested, four-fold or greater increases in titers were detected for EA in 12/29 (41%), for EBNA in 7/29 (24%), for VCA-IgG in 4/29 (14%); four-fold decreases in titers were detected in 2/29 (7%) for EA and 12/29 (41%) for EBNA. A significant decline in the titer of anti-HIV antibodies was also demonstrated. It was concluded that patients with advanced HIV infection who respond to HAART have an increase in their EBV specific antibodies and a decrease in their HIV-specific antibodies. For the cohort overall, there was a transient increase in EBV DNA levels that had declined by 12 months. Copyright 2002 Wiley-Liss, Inc.

  10. Epstein-Barr virus and human immunodeficiency virus serological responses and viral burdens in HIV-infected patients treated with HAART

    NASA Technical Reports Server (NTRS)

    O'Sullivan, Cathal E.; Peng, RongSheng; Cole, Kelly Stefano; Montelaro, Ronald C.; Sturgeon, Timothy; Jenson, Hal B.; Ling, Paul D.; Butel, J. S. (Principal Investigator)

    2002-01-01

    Epstein-Barr virus (EBV) associated non-Hodgkin lymphoma is recognized as a complication of human immunodeficiency virus (HIV) infection. Little is known regarding the influence of highly active antiretroviral therapy (HAART) on the biology of EBV in this population. To characterize the EBV- and HIV-specific serological responses together with EBV DNA levels in a cohort of HIV-infected adults treated with HAART, a study was conducted to compare EBV and HIV serologies and EBV DNA copy number (DNAemia) over a 12-month period after the commencement of HAART. All patients were seropositive for EBV at baseline. Approximately 50% of patients had detectable EBV DNA at baseline, and 27/30 had detectable EBV DNA at some point over the follow-up period of 1 year. Changes in EBV DNA copy number over time for any individual were unpredictable. Significant increases in the levels of Epstein-Barr nuclear antigen (EBNA) and Epstein-Barr early antigen (EA) antibodies were demonstrated in the 17 patients who had a good response to HAART. Of 29 patients with paired samples tested, four-fold or greater increases in titers were detected for EA in 12/29 (41%), for EBNA in 7/29 (24%), for VCA-IgG in 4/29 (14%); four-fold decreases in titers were detected in 2/29 (7%) for EA and 12/29 (41%) for EBNA. A significant decline in the titer of anti-HIV antibodies was also demonstrated. It was concluded that patients with advanced HIV infection who respond to HAART have an increase in their EBV specific antibodies and a decrease in their HIV-specific antibodies. For the cohort overall, there was a transient increase in EBV DNA levels that had declined by 12 months. Copyright 2002 Wiley-Liss, Inc.

  11. Methodology for HIV disinfectant testing.

    PubMed

    van Bueren, J

    1995-06-01

    Due to the variation in protocols from studies by different workers for the inactivation of HIV by chemical disinfectants, only limited comparisons of the results can be made. These variations include those which apply to disinfectant testing in general, such as the level of organic load and the form of neutralization of the disinfectant, and those which apply particularly to HIV inactivation, such as the method used to detect infectious virus. Our suspension and carrier tests to assess the efficacy of chemical disinfectants against HIV are described and problems with the interpretation and applicability of the results are discussed.

  12. A proficiency testing method for detecting antibodies against Brucella abortus in quantitative and qualitative serological tests.

    PubMed

    Gall, D; Nielsen, K; Nicola, A; Renteria, T

    2008-12-01

    A proficiency testing panel for detecting antibodies against Brucella abortus was developed and evaluated by both primary binding and conventional serological tests, using the guidelines of the World Organisation for Animal Health and the International Organization for Standardization Guide 43-1. All serological tests were judged satisfactory. Among the primary binding tests, the competitive enzyme-linked immunosorbent assay (ELISA 2) and the indirect enzyme-linked immunosorbent assay (ELISA 1), with standard deviation indices (z-scores) of -0.06 and 0.10, respectively, performed best. Similarly, E(n) numbers (i.e. a way of comparing different measurements of performance) of 0 for both the competitive ELISA 2 and the indirect ELISA 1 indicated that these tests performed best in the initial round of proficiency testing. The conventional serological tests all passed the panel. Comparing data from both the quantitative and qualitative tests demonstrated that this proficiency testing scheme was fit for the purpose for which it was designed.

  13. Serological screening for sexually transmitted infections in pregnancy: is there any value in re-screening for HIV and syphilis at the time of delivery?

    PubMed Central

    Qolohle, D C; Hoosen, A A; Moodley, J; Smith, A N; Mlisana, K P

    1995-01-01

    OBJECTIVE--The aim of this study was to assess the prevalence of syphilis, human immunodeficiency virus (HIV), and hepatitis B virus (HBV) infections in women at the time of delivery, and to determine the seroconversion rates for syphilis and HIV infections from initial booking visit to delivery. SETTING--The labour ward of a typical tertiary hospital in a developing country and serving an indigent African population. METHOD--Four hundred and eighteen women presenting in labour were randomly selected and informed consent obtained for serological testing for syphilis and HBV infections in umbilical cord blood samples. The specimens were then given a study number, the gestational ages recorded and anonymously tested for HIV infection. RESULTS--Of the 191 women who had antenatal care, 13 (6.8%) were HIV antibody positive at the initial "booking" visit. An additional 4 were found to be HIV antibody positive at the time of delivery resulting in a seroconversion rate of 2.2%. The seroconversion rate for syphilis at the time of delivery was 2.7%. Hepatitis B surface antigens were detected in only 2 women, one of whom was antigen positive. CONCLUSION--The high seroconversion rates for both syphilis and HIV infection in pregnancy justifies re-screening for these conditions in endemic areas such as ours. PMID:7744414

  14. Rapid and simple screening and supplemental testing for HIV-1 and HIV-2 infections in west Africa.

    PubMed

    Brattegaard, K; Kouadio, J; Adom, M L; Doorly, R; George, J R; De Cock, K M

    1993-06-01

    Researchers from an AIDS research project took blood samples from 1000 consecutive women during childbirth at a maternal and child health center in Abidjan, Cote d'Ivoire, and from 185 hospitalized patients to compare the results of a combination of synthetic peptide-based rapid tests (product names, Testpack and Genie), which check for HIV-1 and HIV-2 antibodies, with those of the Western Blot-based test. They also wanted to see whether the rapid test-based strategy could replace the Western Blot-based test as a supplemental test. The Western Blot indicated the HIV-1 and/or HIV-2 prevalence to be 13% among the new mothers and 78% among the hospitalized patients for an overall prevalence of 23%. 3.3% of all people were positive for both HIV-1 and HIV-2. 17.4% tested positive for just HIV-1. 2.1% were positive for HIV-2. The rapid tests had a sensitivity of 99.6% and a specificity of 99.9%. The positive predictive value was 99.6% and the negative predictive value was 99.9%. The rapid tests identified 4% of the HIV-2 positive samples and 1% of the HIV-1 samples to be dually reactive. These findings demonstrated that rapid synthetic peptide-based assays reliably detect HIV-1 and HIV-2 antibodies and can be supplemental tests. High quality HIV serology can be performed in a setting without running water and electricity which was the case in this study. A further advantage of this strategy is that each test takes only 10 minutes. These tests would have significant effects on HIV testing and counseling, diagnosis, and screening of blood for transfusion in rural areas of developing countries.

  15. HIV Testing Characteristics Among Hispanic Adolescents.

    PubMed

    Ma, Mindy; Malcolm, Lydia; Diaz-Albertini, Kristine; Klinoff, Vera A

    2016-02-01

    Hispanic adolescents are disproportionally impacted by HIV/AIDS. Among Hispanic people living with HIV, delayed testing and late entry into HIV care have been documented. The current study examined Hispanic adolescents' HIV testing characteristics and factors related to testing. Adolescents aged 13-16 (N = 223) completed a survey on HIV testing motivation, perceptions, and experience, sexual behavior, and substance use. Results indicate few adolescents (9%) had taken an HIV test. Among those who have not been tested, 32.5% expressed interest in testing. HIV testing was favorably perceived with 82.4% reported testing should be done with all youth or those are sexually active. Adolescents who had engaged in high risk behaviors (history of sexual intercourse, substance use) were more likely to have been tested or to express interest in testing. Given that HIV testing is positively perceived by Hispanic adolescents, prevention efforts should focus on minimizing barriers and enhancing accessibility to HIV screening.

  16. The INSTI HIV-1/HIV-2 antibody test: a review.

    PubMed

    Singh, Ameeta E; Lee, Bonita; Fenton, Jayne; Preiksaitis, Jutta

    2013-05-01

    Rapid HIV tests have been widely adopted globally as an important component of HIV prevention and control programs. The INSTI™ HIV-1/HIV-2 antibody test is a second-generation HIV antibody test, available in most countries for use from whole blood, serum, and plasma. Available data on kit characteristics and current performance data on the INSTI™ HIV-1/HIV-2 antibody test are presented together with six other rapid point-of-care tests (RPOCTs) for HIV antibody. Few published data are available providing direct comparisons of INSTI™ with other RPOCTs for HIV antibody and standard laboratory-based HIV-1/HIV-2 antibody assays. Existing data showed that INSTI™ has comparable performance to other RPOCTs but detected seroconversion later than standard laboratory-based assays. The good performance of INSTI HIV-1/HIV-2 antibody test, its ease of use, the rapid availability of results (< 5 min), and the lack of specialized equipment required to use the kit make this kit a useful addition to the global market. The unique antigen and flow through technology contained in the kit make it a strong addition to HIV RPOCTs and to rapid/rapid algorithms used in many resource-limited settings.

  17. HIV serology among Italian male military recruits at entrance and discharge.

    PubMed

    Carducci, A; Giorgi, M; Benedettini, G; Avio, C M; Bendinelli, M

    1990-12-01

    To evaluate the usefulness of anti-HIV mass screenings, we examined 662 new military recruits and 1353 soldiers being discharged. None of the former and only one of the latter (0.07%) resulted seropositive on repeated ELISA and Western-blot. For comparison we also report the results of routine anti-HIV antibody testing in our diagnostic laboratory: the highest proportion of seropositive subjects was found among symptomatic patients (79%), followed by haemophiliac patients (31%), drug addicts (24%), sexual partners of seropositive subjects (21%), prisoners (5%) and homosexual men (5%). Health care personnel and prison guards were all negative. These data confirm that in Italy HIV infection is still relatively confined to the classic risk groups. While generalized screening during military service seems to be excessive, periodic sample surveys could be very useful to follow the evolution of HIV epidemiology.

  18. [Malaria serology test: what contribution does it make in an endemic country such as Ivory Coast?

    PubMed

    Goran-Kouacou, Amah Patricia Victorine; Dou, Gonat Serge; Zika, Kalou Dibert; Adou, Adjoumanvoulé Honoré; Yéboah, Oppong Richard; Aka, Rita Ahou; Hien, Sansan; Siransy, Kouabla Liliane; N'Guessan, Koffi; Djibangar, Tariam Agnès; Dassé, Séry Romuald; Adoubryn, Koffi Daho

    2017-01-01

    Malaria serology test seems to have attracted very little interest in endemic countries such as Ivory Coast. However, this examination has been regularly performed in the parasitology laboratory at the Training and Research Unit of Medical Sciences in Abidjan. Our study aimed to highlight the contribution of malaria serology test in our endemic country context. We conducted a retrospective study of malaria serology test using Falciparum-Spot IF (bioMerieux) kit for the detection of IgG antiplasmodial antibodies. It included all malaria serology tests performed from January 2007 to February 2011 and whose results were available in the registry. In total, 136 patients were selected. The average age of patients was 36,3 years, ranging from 1 to 81 years, and sex ratio was 0,97. Indications for malaria serology test were varied and dominated by splenomegaly (49.3%), cytopenias (14.7%), indeterminate fever (13.2%). Almost all of the patients (98.5%) had antiplasmodial antibodies with high medium titer of 1057,35IU/ml. There was no link between age and Ab titer, which was higher in cytopenias, prolonged fevers and the splenomegaly. Malaria serology test seems to have attracted very little interest in routine clinical practice provided in our endemic area because, whatever the reason of the prescription, titers were high.

  19. Serological Analysis of Tuberculosis in Goats by Use of the Enferplex Caprine TB Multiplex Test.

    PubMed

    O'Brien, Amanda; Whelan, Clare; Clarke, John B; Hayton, Alastair; Watt, Neil J; Harkiss, Gordon D

    2017-02-01

    Tuberculosis in goats is usually diagnosed clinically, at postmortem, or by a positive skin test. However, none of these approaches detects all infected animals. Serology offers an additional tool to identify infected animals missed by current tests. We describe the use of the Enferplex Caprine TB serology test to aid the management of a large dairy goat herd undergoing a tuberculosis breakdown. Initial skin and serology testing showed that IgG antibodies were present in both serum and milk from 100% of skin test-positive animals and in serum and milk from 77.8 and 95.4% of skin test-negative animals, respectively. A good correlation was observed between serum and milk antibody levels. The herd had been vaccinated against Mycobacterium avium subsp. paratuberculosis, but no direct serological cross-reactions were found. Subsequent skin testing revealed 13.7% positive animals, 64.9% of which were antibody positive, while 42.1% of skin test-negative animals were seropositive. Antibody responses remained high 1 month later (57.1% positive), and the herd was slaughtered. Postmortem analysis of 20 skin test-negative goats revealed visible lesions in 6 animals, all of which had antibodies to six Mycobacterium bovis antigens. The results provide indirect evidence that serology testing with serum or milk could be a useful tool in the diagnosis and management of tuberculosis in goats. Copyright © 2017 American Society for Microbiology.

  20. Serological Analysis of Tuberculosis in Goats by Use of the Enferplex Caprine TB Multiplex Test

    PubMed Central

    O'Brien, Amanda; Whelan, Clare; Clarke, John B.; Hayton, Alastair; Watt, Neil J.

    2016-01-01

    ABSTRACT Tuberculosis in goats is usually diagnosed clinically, at postmortem, or by a positive skin test. However, none of these approaches detects all infected animals. Serology offers an additional tool to identify infected animals missed by current tests. We describe the use of the Enferplex Caprine TB serology test to aid the management of a large dairy goat herd undergoing a tuberculosis breakdown. Initial skin and serology testing showed that IgG antibodies were present in both serum and milk from 100% of skin test-positive animals and in serum and milk from 77.8 and 95.4% of skin test-negative animals, respectively. A good correlation was observed between serum and milk antibody levels. The herd had been vaccinated against Mycobacterium avium subsp. paratuberculosis, but no direct serological cross-reactions were found. Subsequent skin testing revealed 13.7% positive animals, 64.9% of which were antibody positive, while 42.1% of skin test-negative animals were seropositive. Antibody responses remained high 1 month later (57.1% positive), and the herd was slaughtered. Postmortem analysis of 20 skin test-negative goats revealed visible lesions in 6 animals, all of which had antibodies to six Mycobacterium bovis antigens. The results provide indirect evidence that serology testing with serum or milk could be a useful tool in the diagnosis and management of tuberculosis in goats. PMID:27974399

  1. Coccidioidomycosis: adenosine deaminase levels, serologic parameters, culture results, and polymerase chain reaction testing in pleural fluid.

    PubMed

    Thompson, George R; Sharma, Shobha; Bays, Derek J; Pruitt, Rachel; Engelthaler, David M; Bowers, Jolene; Driebe, Elizabeth M; Davis, Michael; Libke, Robert; Cohen, Stuart H; Pappagianis, Demosthenes

    2013-03-01

    In a patient with positive serum serology for coccidioidomycosis, the differential diagnosis of concurrent pleural effusions can be challenging. We, therefore, sought to clarify the performance characteristics of biochemical, serologic, and nucleic-acid-based testing in an attempt to avoid invasive procedures. The utility of adenosine deaminase (ADA), coccidioidal serology, and polymerase chain reaction (PCR) in the evaluation of pleuropulmonary coccidioidomycosis has not been previously reported. Forty consecutive patients evaluated for pleuropulmonary coccidioidomycosis were included. Demographic data, pleural fluid values, culture results, and clinical diagnoses were obtained from patient chart review. ADA testing was performed by ARUP Laboratories, coccidioidal serologic testing was performed by the University of California-Davis coccidioidomycosis serology laboratory, and PCR testing was performed by the Translational Genomics Research Institute using a previously published methodology. Fifteen patients were diagnosed with pleuropulmonary coccidioidomycosis by European Organization for the Research and Treatment of Cancer/Mycoses Study Group criteria. Pleural fluid ADA concentrations were < 40 IU/L in all patients (range, < 1.0-28.6 IU/L; median, 4.7). The sensitivity and specificity of coccidioidal serologic testing was 100% in this study. The specificity of PCR testing was high (100%), although the overall sensitivity remained low, and was comparable to the experience of others in the clinical use of PCR for coccidioidal diagnostics. Contrary to prior speculation, ADA levels in pleuropulmonary coccidioidomycosis were not elevated in this study. The sensitivity and specificity of coccidioidal serologic testing in nonserum samples remained high, but the clinical usefulness of PCR testing in pleural fluid was disappointing and was comparable to pleural fluid culture.

  2. Development of a rapid equine serological test (REST) by modified agar-gel immunodiffusion.

    PubMed

    Cutrufelli, M E; Mageau, R P; Schwab, B; Johnston, R W

    1991-01-01

    A rapid equine serological test (REST) has been developed for detection of horse meat in a wide variety of raw meat products. The test is an adaptation of previously developed field screening immunodiffusion tests for beef, poultry, pork, and sheep detection. Results show that the REST test was specific, sensitive, and accurate in the analysis of 101 samples.

  3. A cross-sectional serological study of cysticercosis, schistosomiasis, toxocariasis and echinococcosis in HIV-1 infected people in Beira, Mozambique.

    PubMed

    Noormahomed, Emilia Virginia; Nhacupe, Noémia; Mascaró-Lazcano, Carmen; Mauaie, Manuel Natane; Buene, Titos; Funzamo, Carlos Abel; Benson, Constance Ann

    2014-09-01

    Helminthic infections are highly endemic in Mozambique, due to limited access to healthcare and resources for disease prevention. Data on the subclinical prevalence of these diseases are scarce due to the fact that an immunological and imaging diagnosis is not often available in endemic areas. We conducted a cross-sectional study on HIV1(+) patients from Beira city in order to determine the seroprevalence of cysticercosis, schistosomiasis, toxocariasis and echinoccocosis and its possible interaction with HIV infection. Patients (601) were voluntarily recruited at the Ponta Gea Health Center and their demographic and clinical data were recorded (including CD4(+) cell count and antiretroviral regimen). Mean age was 39.7 years, 378 (62.9%) were women and 223 (37.1%) were men. Four hundred seventy-five (475) patients (79%) were already on highly active antiretroviral therapy (HAART), and 90 started therapy after being enrolled in the study. For serological testing we used a Multiplex Western Blot IgG from LDBIO Diagnostics. The overall seroprevalence was 10.2% for cysticercosis, 23% for schistosomiasis, 7.3% for toxocariasis and 17.3% for echinococcosis. Neither age nor the CD4(+) count were significantly associated with the seroprevalence of the helminths studied. However, patients with CD4(+) between 200-500/µl had a higher seroprevalence to all helminths than those with less than 200/µl cells/and those with more than 500 cells/µl. Female gender was significantly associated with cysticercosis and schistosomiasis, and being in HAART with toxocariasis. Headache was significantly associated with cysticercosis and toxocariasis. There was no association between epilepsy and seropositivity to any of the parasites. The study concluded that a clear understanding of the prevalence and manifestations of these coinfections, how best to diagnose subclinical cases, and how to manage diseases with concomitant antiretroviral therapy is needed.

  4. A Cross-sectional Serological Study of Cysticercosis, Schistosomiasis, Toxocariasis and Echinococcosis in HIV-1 Infected People in Beira, Mozambique

    PubMed Central

    Noormahomed, Emilia Virginia; Nhacupe, Noémia; Mascaró-Lazcano, Carmen; Mauaie, Manuel Natane; Buene, Titos; Funzamo, Carlos Abel; Benson, Constance Ann

    2014-01-01

    Background Helminthic infections are highly endemic in Mozambique, due to limited access to healthcare and resources for disease prevention. Data on the subclinical prevalence of these diseases are scarce due to the fact that an immunological and imaging diagnosis is not often available in endemic areas. We conducted a cross-sectional study on HIV1+ patients from Beira city in order to determine the seroprevalence of cysticercosis, schistosomiasis, toxocariasis and echinoccocosis and its possible interaction with HIV infection. Methodology/Principal Findings Patients (601) were voluntarily recruited at the Ponta Gea Health Center and their demographic and clinical data were recorded (including CD4+ cell count and antiretroviral regimen). Mean age was 39.7 years, 378 (62.9%) were women and 223 (37.1%) were men. Four hundred seventy-five (475) patients (79%) were already on highly active antiretroviral therapy (HAART), and 90 started therapy after being enrolled in the study. For serological testing we used a Multiplex Western Blot IgG from LDBIO Diagnostics. The overall seroprevalence was 10.2% for cysticercosis, 23% for schistosomiasis, 7.3% for toxocariasis and 17.3% for echinococcosis. Conclusions/Significance Neither age nor the CD4+ count were significantly associated with the seroprevalence of the helminths studied. However, patients with CD4+ between 200–500/µl had a higher seroprevalence to all helminths than those with less than 200/µl cells/and those with more than 500 cells/µl. Female gender was significantly associated with cysticercosis and schistosomiasis, and being in HAART with toxocariasis. Headache was significantly associated with cysticercosis and toxocariasis. There was no association between epilepsy and seropositivity to any of the parasites. The study concluded that a clear understanding of the prevalence and manifestations of these coinfections, how best to diagnose subclinical cases, and how to manage diseases with concomitant

  5. Serological tests in gluten sensitivity (nonceliac gluten intolerance).

    PubMed

    Volta, Umberto; Tovoli, Francesco; Cicola, Ronny; Parisi, Claudia; Fabbri, Angela; Piscaglia, Maria; Fiorini, Erica; Caio, Giacomo

    2012-09-01

    To characterize the serological pattern of gluten sensitivity (GS) and to compare it with that found in celiac disease. GS has recently been identified as a new clinical entity included in the spectrum of gluten-related disorders, but it is still lacking of diagnostic markers. Sera from 78 patients with GS and 80 patients with celiac disease were retrospectively assessed for immunoglobulin (Ig)G/IgA antigliadin antibodies (AGA), IgG deamidated gliadin peptide antibodies (DGP-AGA), IgA tissue transglutaminase antibodies (tTGA), and IgA endomysial antibodies (EmA). IgG AGA were positive in 56.4% of GS patients and in 81.2% of celiac patients, with high antibody titers in both groups. IgA AGA were detected in 7.7% of GS patients and in 75% of celiac patients, showing lower enzyme-linked immunosorbent assay activities in GS than those found in celiac disease. Only 1 of the 78 patients with GS was positive for IgG DGP-AGA (detected in 88.7% of patients with celiac disease). IgA tTGA and IgA EmA were negative in all GS patients, whereas their positivity in celiac patients was 98.7% and 95%, respectively. Patients with GS displayed a variegated clinical picture with intestinal and extraintestinal symptoms (abdominal pain, bloating, diarrhea, constipation, foggy mind, tiredness, eczema/skin rash, headache, joint/muscle pain, numbness of legs/arms, depression, and anemia) together with normal or mildly abnormal small intestinal mucosa. The serological pattern of GS is characterized by IgG AGA positivity in more than half of cases associated to IgA AGA in a few patients, but without EmA, tTGA, and DGP-AGA, which are the specific markers of celiac disease.

  6. Rapid HIV test in family practice.

    PubMed

    Poirier, C; Aymeric, S; Grammatico-Guillon, L; Lebeau, J P; Bernard, L; Le Bret, P; Le Moal, G; Gras, G

    2015-06-01

    The 2010-2014 HIV/AIDS French program recommends using HIV rapid diagnostic tests in family practice. Our aim was to assess the acceptability and feasibility of the RDT in family practice in France. The first part of this study was to determine the opinions of family practitioners (FPs) concerning the news guidelines for screening and the possible use of rapid HIV tests in their practice. The second part was a feasibility study of the actual use of rapid HIV tests given to FPs during six months. The third part was a qualitative analysis of experience feedback to determine the impediments to using rapid HIV tests. Seventy-seven percent of the 352 FPs interviewed were favorable to rapid HIV tests use. The three main impediments were: misinterpretation of test result, complexity of quality control, and lack of training: 23 of the 112 FPs having volunteered to evaluate the rapid HIV tests followed the required training session. Sixty-nine tests were handed out, and three rapid HIV tests were used; the qualitative study involved 12 FPs. The participants all agreed on the difficult use of rapid HIV tests in daily practice. The main reasons were: too few opportunities or requests for use, complex handling, difficulties in proposing the test, fear of having to announce seropositivity, significantly longer consultation. Although FPs are generally favorable to rapid HIV tests use in daily practice, the feasibility and contribution of rapid HIV tests are limited in family practice. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. Results of the National External Quality Assessment for Toxoplasmosis Serological Testing in China

    PubMed Central

    Zhang, Kuo; Wang, Lunan; Lin, Guigao; Sun, Yu; Zhang, Rui; Xie, Jiehong; Li, Jinming

    2015-01-01

    Background Toxoplasmosis is typically diagnosed by serologic testing. External quality assessment (EQA) of clinical laboratories could ensure the accuracy and reliability of serological tests. We assessed the quality of toxoplasma serological assays in Chinese clinical laboratories by an EQA performed between 2004 and 2013 by the National Center for Clinical Laboratories. Methodology and Findings EQA panels were prepared and shipped at room temperature to participating laboratories that employed toxoplasma IgG and IgM serological detection. By 2013, 5,384 EQA test reports for toxoplasma-specific IgM and 2,666 reports for toxoplasma-specific IgG were collected. Enzyme-linked immunosorbent (ELISA) and chemical immunofluorescent assays were the most commonly used detection methods. The overall coincidence rates of negative samples were better than those of positive samples. The overall EQA score for toxoplasma-specific IgM detection ranged between 84.3% and 99.6%. The ratio of laboratories that achieved correct IgG detection ranged from 61.1% to 99.3%. However, the inter- and intra-assay variabilities were found to be considerable. The most common problem was failure to detect low titers of antibody. Conclusion The EQA scheme showed an improvement in toxoplasma serological testing in China. However, further optimization of assay sensitivity to detect challenging samples remains a future challenge. PMID:26066047

  8. Just Diagnosed: Next Steps After Testing Positive for HIV

    MedlinePlus

    HIV Treatment Just Diagnosed: Next Steps After Testing Positive for HIV (Last updated 3/13/2017; last reviewed 3/ ... is the next step after testing positive for HIV? Testing positive for HIV often leaves a person ...

  9. HIV Testing on Campus: The Next Step.

    ERIC Educational Resources Information Center

    Hayden, Joanna

    1994-01-01

    Sees first phase in human immunodeficiency virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) prevention on many campuses to be focused on education. Calls second phase HIV testing for early diagnosis. Explains steps taken to implement HIV testing program on suburban campus and discusses student program evaluation. (Author/NB)

  10. Heterogeneity of Leishmania donovani parasites complicates diagnosis of visceral leishmaniasis: comparison of different serological tests in three endemic regions.

    PubMed

    Abass, Elfadil; Kang, Cholho; Martinkovic, Franjo; Semião-Santos, Saul J; Sundar, Shyam; Walden, Peter; Piarroux, Renaud; El Harith, Abdallah; Lohoff, Michael; Steinhoff, Ulrich

    2015-01-01

    Diagnostic tests for visceral leishmaniasis that are based on antigens of a single Leishmania strain can have low diagnostic performance in regions where heterologous parasites predominate. The aim of this study was to investigate and compare the performance of five serological tests, based on different Leishmania antigens, in three endemic countries for visceral leishmaniasis. A total number of 231 sera of symptomatic and asymptomatic cases and controls from three endemic regions of visceral leishmaniasis in East Sudan, North India and South France were evaluated by following serological tests: rKLO8- and rK39 ELISA, DAT (ITMA-DAT) and two rapid tests of rK39 (IT LEISH) and rKE16 (Signal-KA). Overall, rKLO8- and rK39 ELISA were most sensitive in immunocompetent patients from all endemic regions (96-100%) and the sensitivity was reduced to 81.8% in HIV co-infected patients from France. Sera of patients from India demonstrated significantly higher antibody responses to rKLO8 and rK39 compared with sera from Sudan (p<0.0001) and France (p<0.0037). Further, some Indian and Sudanese patients reacted better with rKLO8 than rK39. Sensitivity of DAT (ITMA-DAT) was high in Sudan (94%) and India (92.3%) but low in France being 88.5% and 54.5% for VL and VL/HIV patients, respectively. In contrast, rapid tests displayed high sensitivity only in patients from India (96.2%) but not Sudan (64-88%) and France (73.1-88.5% and 63.6-81.8% in VL and VL/HIV patients, respectively). While the sensitivity varied, all tests showed high specificity in Sudan (96.7-100%) and India (96.6%).Heterogeneity of Leishmania parasites which is common in many endemic regions complicates the diagnosis of visceral leishmaniasis. Therefore, tests based on homologous Leishmania antigens are required for particular endemic regions to detect cases which are difficult to be diagnosed with currently available tests.

  11. Strategic use of serology for the diagnosis of bovine tuberculosis after intradermal skin testing.

    PubMed

    Casal, Carmen; Díez-Guerrier, Alberto; Álvarez, Julio; Rodriguez-Campos, Sabrina; Mateos, Ana; Linscott, Richard; Martel, Edmond; Lawrence, John C; Whelan, Clare; Clarke, John; O'Brien, Amanda; Domínguez, Lucas; Aranaz, Alicia

    2014-06-04

    Diagnostic tests based on cell-mediated immunity are used in programmes for eradication of bovine tuberculosis (Mycobacterium bovis). Serological assays could be applied as ancillary methods to detect infected animals. Our objective was to evaluate two serological techniques: M. bovis Ab Test (IDEXX, USA) and Enferplex™ TB assay (Enfer, Ireland) in animals tested simultaneously with the single and comparative intradermal tests and the interferon-gamma assay. This work was performed at two stages. First, a preliminary panel of samples collected prior to intradermal tests from tuberculosis-free (n=60) and M. bovis-infected herds (n=78) was assayed, obtaining high specificity: 100% (M. bovis Ab Test) and 98.3% (Enferplex TB assay) but low sensitivity (detection of M. bovis infected animals): 23.9% (M. bovis Ab Test) and 32.6% (Enferplex TB assay). Subsequently, the use of serological techniques was further studied in two herds with M. bovis infection (n=77) using samples collected prior to, and 72 h and 15 days after PPD inoculation. The highest level of detection of infected animals for serology was achieved at 15 days post-intradermal tests taking advantage of the anamnestic effect: 70.4% and 85.2% in herd A, and 66.7% and 83.3% in herd B, using M. bovis Ab Test and Enferplex TB assay, respectively. Quantitative results (average values obtained with M. bovis Ab Test ELISA and degree of positivity obtained with Enferplex TB assay) were higher in animals showing lesions compatible with tuberculosis. No significant differences were observed in the number of confirmed infected animals detected with either serological technique. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Clinical utility of serologic testing for celiac disease in ontario: an evidence-based analysis.

    PubMed

    2010-01-01

    OBJECTIVE OF ANALYSIS: The objective of this evidence-based evaluation is to assess the accuracy of serologic tests in the diagnosis of celiac disease in subjects with symptoms consistent with this disease. Furthermore the impact of these tests in the diagnostic pathway of the disease and decision making was also evaluated. CELIAC DISEASE: Celiac disease is an autoimmune disease that develops in genetically predisposed individuals. The immunological response is triggered by ingestion of gluten, a protein that is present in wheat, rye, and barley. The treatment consists of strict lifelong adherence to a gluten-free diet (GFD). Patients with celiac disease may present with a myriad of symptoms such as diarrhea, abdominal pain, weight loss, iron deficiency anemia, dermatitis herpetiformis, among others. There are a number of serologic tests used in the diagnosis of celiac disease. Anti-gliadin antibody (AGA)Anti-endomysial antibody (EMA)Anti-tissue transglutaminase antibody (tTG)Anti-deamidated gliadin peptides antibodies (DGP)Serologic tests are automated with the exception of the EMA test, which is more time-consuming and operator-dependent than the other tests. For each serologic test, both immunoglobulin A (IgA) or G (IgG) can be measured, however, IgA measurement is the standard antibody measured in celiac disease. According to celiac disease guidelines, the diagnosis of celiac disease is established by small bowel biopsy. Serologic tests are used to initially detect and to support the diagnosis of celiac disease. A small bowel biopsy is indicated in individuals with a positive serologic test. In some cases an endoscopy and small bowel biopsy may be required even with a negative serologic test. The diagnosis of celiac disease must be performed on a gluten-containing diet since the small intestine abnormalities and the serologic antibody levels may resolve or improve on a GFD. Since IgA measurement is the standard for the serologic celiac disease tests, false

  13. Poor Positive Predictive Value of Lyme Disease Serologic Testing in an Area of Low Disease Incidence.

    PubMed

    Lantos, Paul M; Branda, John A; Boggan, Joel C; Chudgar, Saumil M; Wilson, Elizabeth A; Ruffin, Felicia; Fowler, Vance; Auwaerter, Paul G; Nigrovic, Lise E

    2015-11-01

    Lyme disease is diagnosed by 2-tiered serologic testing in patients with a compatible clinical illness, but the significance of positive test results in low-prevalence regions has not been investigated. We reviewed the medical records of patients who tested positive for Lyme disease with standardized 2-tiered serologic testing between 2005 and 2010 at a single hospital system in a region with little endemic Lyme disease. Based on clinical findings, we calculated the positive predictive value of Lyme disease serology. Next, we reviewed the outcome of serologic testing in patients with select clinical syndromes compatible with disseminated Lyme disease (arthritis, cranial neuropathy, or meningitis). During the 6-year study period 4723 patients were tested for Lyme disease, but only 76 (1.6%) had positive results by established laboratory criteria. Among 70 seropositive patients whose medical records were available for review, 12 (17%; 95% confidence interval, 9%-28%) were found to have Lyme disease (6 with documented travel to endemic regions). During the same time period, 297 patients with a clinical illness compatible with disseminated Lyme disease underwent 2-tiered serologic testing. Six of them (2%; 95% confidence interval, 0.7%-4.3%) were seropositive, 3 with documented travel and 1 who had an alternative diagnosis that explained the clinical findings. In this low-prevalence cohort, fewer than 20% of positive Lyme disease tests are obtained from patients with clinically likely Lyme disease. Positive Lyme disease test results may have little diagnostic value in this setting. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Poor Positive Predictive Value of Lyme Disease Serologic Testing in an Area of Low Disease Incidence

    PubMed Central

    Lantos, Paul M.; Branda, John A.; Boggan, Joel C.; Chudgar, Saumil M.; Wilson, Elizabeth A.; Ruffin, Felicia; Fowler, Vance; Auwaerter, Paul G.; Nigrovic, Lise E.

    2015-01-01

    Background. Lyme disease is diagnosed by 2-tiered serologic testing in patients with a compatible clinical illness, but the significance of positive test results in low-prevalence regions has not been investigated. Methods. We reviewed the medical records of patients who tested positive for Lyme disease with standardized 2-tiered serologic testing between 2005 and 2010 at a single hospital system in a region with little endemic Lyme disease. Based on clinical findings, we calculated the positive predictive value of Lyme disease serology. Next, we reviewed the outcome of serologic testing in patients with select clinical syndromes compatible with disseminated Lyme disease (arthritis, cranial neuropathy, or meningitis). Results. During the 6-year study period 4723 patients were tested for Lyme disease, but only 76 (1.6%) had positive results by established laboratory criteria. Among 70 seropositive patients whose medical records were available for review, 12 (17%; 95% confidence interval, 9%–28%) were found to have Lyme disease (6 with documented travel to endemic regions). During the same time period, 297 patients with a clinical illness compatible with disseminated Lyme disease underwent 2-tiered serologic testing. Six of them (2%; 95% confidence interval, 0.7%–4.3%) were seropositive, 3 with documented travel and 1 who had an alternative diagnosis that explained the clinical findings. Conclusions. In this low-prevalence cohort, fewer than 20% of positive Lyme disease tests are obtained from patients with clinically likely Lyme disease. Positive Lyme disease test results may have little diagnostic value in this setting. PMID:26195017

  15. Distance to public test sites and HIV testing.

    PubMed

    Leibowitz, Arleen A; Taylor, Stephanie L

    2007-10-01

    This article examines how proximity to the nearest publicly funded test site affects HIV testing. Using a sample of 5,361 Los Angeles County adults, multinomial logit models estimated simultaneously the likelihood of (1) obtaining an HIV test in the prior 2 years, and (2) testing in a private physician's office, a publicly funded medical clinic, or in a nonmedical setting, such as a bar or bathhouse. Low-income Los Angeles residents rely on publicly funded sites for HIV testing. When public sites are more distant, poor individuals are less likely to use them and less likely to get tested. Distance from public sites does not affect HIV testing among the nonpoor. To encourage HIV testing among the groups where HIV is growing fastest, public health agencies must keep the time and money costs of HIV testing low.

  16. 21 CFR 866.3390 - Neisseria spp. direct serological test reagents.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Neisseria spp. direct serological test reagents. 866.3390 Section 866.3390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... conjugated with a fluorescent dye (immunofluorescent reagents) which may be used to detect the presence...

  17. 21 CFR 866.3390 - Neisseria spp. direct serological test reagents.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Neisseria spp. direct serological test reagents. 866.3390 Section 866.3390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... conjugated with a fluorescent dye (immunofluorescent reagents) which may be used to detect the presence...

  18. 21 CFR 866.3390 - Neisseria spp. direct serological test reagents.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Neisseria spp. direct serological test reagents. 866.3390 Section 866.3390 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... conjugated with a fluorescent dye (immunofluorescent reagents) which may be used to detect the presence...

  19. Comparison of 2 serologic tests for the diagnosis of porcine proliferative enteropathy

    PubMed Central

    2005-01-01

    Abstract The purpose of this study was to compare results from 2 serological assays at the individual- and herd-level for porcine proliferative enteropathy diagnosis. Cohen’s kappa coefficient (k) was used to measure agreement. The tests tend to show better agreement when used at the herd level. PMID:16018563

  20. Nucleic acid testing and tissue safety: an eye bank's five-year review of HIV and hepatitis testing for donor corneas.

    PubMed

    Heck, Ellen; Brown, Allen; Cavanagh, H Dwight

    2013-04-01

    Tissue safety and added testing is a frequent topic of discussion among those who must evaluate donor suitability and assure appropriate testing. Therefore, the purpose of this report was to examine the data of one eye bank (accredited by Eye Bank Association of America) for the presence or absence of reactive serology in 3592 donors over a 5-year period, from 2005 to 2010. The number of specific analytes, human immunodeficiency virus (HIV), hepatitis B virus, or hepatitis C virus, that were reactive and the number of multireactive serologies are presented along with reports related to the identification of nucleic acid testing (NAT), NAT-reactive donors in correlation with other antigen or antibody markers. Antigen or antibody markers are enzyme-linked immunosorbent assay immunoassay kit determinations. NATs are used to measure the presence of RNA or DNA virus. The 249 donors with reactive serologies serve to confirm the importance of serologic testing in history-negative potential donors. Furthermore, the findings of 2 HIV NAT-only reactive individuals is significant because it may indicate an early unrecognized exposure and "window period" infectivity not recognized by antibody testing alone. These results support the appropriate inclusion of this added test to guarantee tissue safety. The finding of 2 potential donors without identified risk factors but with reactive HIV NAT suggests the need for comprehensive serologic testing in conjunction with medical social history screening. Considered together, screening and testing offer the best allograft tissue safety currently available.

  1. 9 CFR 130.16 - User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false User fees for veterinary diagnostic serology tests performed at NVSL (excluding FADDL) or at authorized sites. 130.16 Section 130.16 Animals... USER FEES § 130.16 User fees for veterinary diagnostic serology tests performed at NVSL...

  2. Timing of HIV Seroreversion Among HIV-Exposed, Breastfed Infants in Malawi: Type of HIV Rapid Test Matters.

    PubMed

    Smith, Emily R; Hudgens, Michael; Sheahan, Anna D; Miller, William C; Wheeler, Stephanie; Nelson, Julie A E; Dube, Queen; Van Rie, Annelies

    2017-02-01

    Introduction Rapid HIV serological tests are a cost-effective, point-of-care test among HIV exposed infants but cannot distinguish between maternal and infant antibodies. The lack of data on the timing of decay of maternal antibodies in young infants hinders the potential use of rapid tests in exposed infants. We aimed to determine the time to seroreversion for two commonly used rapid tests in a prospective cohort of HIV-exposed breastfeeding infants ages 3-18 months of life. Methods We collected data on the performance of two commonly used rapid tests (Determine and Unigold) in Malawi between 2008 and 2012 or at the University of North Carolina between 2014 and 2015. Time to seroreversion was estimated for both rapid tests using the Kaplan-Meier product limit estimator which allows for interval censored data. Results At 3 months of age, 3 % of infants had seroreverted according to Determine and 7 % had seroreverted according to Unigold. About one in four infants had achieved seroreversion by 4 months using Unigold, but only about one in twelve infants by 4 months when using Determine. More than 95 % of all infants had seroverted by 7 months according to Unigold and by 12 months according to the Determine assay. Discussion We show that the time of seroreversion depends greatly on the type of test used. Our results highlight the need for recommendations to specify the timing and type of test used in the context of infant HIV detection in resource-poor settings, and base the interpretation of test result on knowledge of time to seroreversion of the selected test.

  3. Risk factors for HIV seropositivity among people consulting for HIV antibody testing: a pilot surveillance study in Quebec.

    PubMed Central

    Alary, M; Castel, J

    1990-01-01

    The surveillance of AIDS (acquired immune deficiency syndrome) through case reporting only reflects the epidemiologic features of HIV (human immunodeficiency virus) transmission a few years earlier and not the prevalence of HIV seropositivity. HIV infection is not a notifiable condition in Quebec. We were asked by the ministère de la Santé et des Services sociaux du Québec to perform a pilot project for the surveillance of HIV seropositivity using a network of sentinel physicians. From May 15, 1988, to Sept. 30, 1989, physicians from four collaborating centres collected data on the serologic status, demographic characteristics and risk factors for 4209 patients who underwent HIV antibody testing. Of the 3899 subjects included in the study 7.9% were HIV positive. Through logistic regression analysis the following variables were found to be significantly associated with HIV seropositivity: presence of HIV-related symptoms (prevalence odds ratio [POR] 36.5), origin from an endemic area (POR 9.1), homosexuality or bisexuality (POR 8.4), intravenous drug use (POR 4.2), male sex (POR 2.8), previous HIV antibody testing (POR 2.5) and previous sexually transmitted disease (POR 1.8). Over the study period we found a large increase in HIV seroprevalence among intravenous drug users (4.2% in 1988 to 19.0% in 1989) (p = 0.02). This increase might reflect a recent change in the epidemiologic pattern of HIV transmission in Quebec. Surveillance of HIV seropositivity through a network of sentinel physicians may be a reasonable alternative to mandatory reporting. PMID:2357678

  4. Serological evidence of Leishmania donovani infection in apparently healthy dogs using direct agglutination test (DAT) and rk39 dipstick tests in Kafta Humera, north-west Ethiopia.

    PubMed

    Kalayou, S; Tadelle, H; Bsrat, A; Abebe, N; Haileselassie, M; Schallig, H D F H

    2011-06-01

    Leishmania (Kinetoplastida: Trypanosomatidae) are protozoan parasites of significant medical and veterinary importance. Over the last decade, visceral leishmaniasis (VL) has emerged as a major opportunistic infection associated with HIV/AIDS in North Western Ethiopia. This paper reports on serological evidence of possible Leishmania donovani (L. donovani) infection in dogs using two serological tests: direct agglutination test (DAT) and Kalazar detect rapid test (KDRT). Two hundred and seventeen asymptomatic local breed dogs were examined for L. donovani antibodies. Performance of the DAT and KDRT was assessed in 162 matching samples of blood collected on filter paper and serum, respectively. Using DAT and KDRT testing in parallel, the overall seroprevalence of L. donovani infection was 27.7% and 14.8%, respectively. The degree of agreement was found to be fair (68.8%, k = 0.234). Univariable logistic regression analysis of some risk factors for L. donovani infection in dogs using DAT indicates that place of residence, sex, age, dog keeping purpose and dog housing condition were not significantly associated with seropositivity. The high proportion of positive dogs suggests the exposure of these animals to L. donovani infection and needs further investigation. Isolation and typing of the parasite aiming at confirming the role of these animals in maintenance and transmission of kala-azar is advocated.

  5. Essential mixed cryoglobulinaemia with false-positive serological tests for syphilis.

    PubMed Central

    Jones, R R; Pusey, C; Schifferli, J; Johnston, N A

    1983-01-01

    Analysis of serum from a patient with cutaneous leukocytoclastic vasculitis showed a mixed cryoglobulin with a monoclonal IgM kappa-antiglobulin component (6.5 mg/ml), strong rheumatoid factor activity (latex titre 1/5000), and positive serological tests for syphilis (fluorescent treponemal antibody-absorbed and Treponema pallidum haemagglutination assay). After removal of antiglobulin activity by immunoabsorption with heat-aggregated gammaglobulin all serological test results for treponemal infection became negative. Serological tests for syphilis and rheumatoid factor on the supernatant from whole serum (minus cryoglobulin) remained positive though at a lower titre (latex 1/1250). Cryoglobulin isolated from whole serum retained rheumatoid and TPHA reactivity but was negative in the FTA-ABS test. The IgM and IgG cryoglobulin components purified by gel filtration on Sepharose showed no antitreponemal reactivity even when tested individually. Reducing the concentration of cryoglobulin to 1.5 mg/ml by plasma exchange converted the test results for syphilis to doubtful-positive or negative. These results indicated that high concentrations of antiglobulin activity may be associated with falsely positive specific antitreponemal test results and that this phenomenon depends on the concentration of cryoglobulin in the test sample. PMID:6824906

  6. Applying HIV testing guidelines in clinical practice.

    PubMed

    Mahoney, Megan R; Fogler, Jess; Weber, Shannon; Goldschmidt, Ronald H

    2009-12-15

    An estimated one fourth of persons with human immunodeficiency virus (HIV) are not aware they are infected. Early diagnosis of HIV has the potential to ensure optimal outcomes for infected persons and to limit the spread of the virus. Important barriers to testing among physicians include insufficient time, reimbursement issues, and lack of patient acceptance. Current HIV testing guidelines address many of these barriers by making the testing process more streamlined and less stigmatizing. The opt-out consent process has been shown to improve test acceptance. Formal pretest counseling and written consent are no longer recommended by the Centers for Disease Control and Prevention. Nevertheless, pretest discussions provide an opportunity to give information about HIV, address fears of discrimination, and identify ongoing high-risk activities. With increased HIV screening in the primary care setting, more persons with HIV could be identified earlier, receive timely and appropriate care, and get treatment to prevent clinical progression and transmission.

  7. Use of HIV-1 specific immunoglobulin G3 as a serological marker of vertical transmission.

    PubMed

    Madurai, S; Moodley, D; Coovadia, H M; Bobat, R A; Gopaul, W; Smith, A N; York, D F

    1996-12-01

    The objective of the study was to indicate HIV infection in infants. The patients were part of a longitudinal cohort of 43 infants born to HIV seropositive mothers. A modified Genelavia EIA primarily directed against HIV envelope proteins was used. An alkaline phosphatase labelled IgG3 conjugate was substituted in place of the kit conjugate. HIV specific IgG3 clearance was optimal at 6 months, whilst HIV total antibody was reliable only from age 12 months onwards. At 6 months no detectable IgG3 were found in 91 per cent of uninfected infants where more of these infants had reduced their total HIV antibody titres at the same period. We confirm that HIV specific IgG3 measurement is a reliable and cost effective means of identifying HIV infected infants from 6 months of age onwards.

  8. Controlling tuberculosis in a llama (Lama glama) herd using clinical signs, tuberculin skin testing and serology.

    PubMed

    Twomey, D F; Collins, R; Cranwell, M P; Crawshaw, T R; Higgins, R J; Dean, G S; Vordermeier, H M; Hollingdale, A; de la Rua-Domenech, R

    2012-05-01

    An outbreak of tuberculosis (TB), caused by Mycobacterium bovis, was investigated in a small herd of llamas (Lama glama). Based on three ante-mortem diagnostic methods (clinical signs, tuberculin skin test reactions, and 'Rapid Test' serology), 12 llamas were selected for examination post-mortem. Grossly visible lesions suspicious of TB were observed in eight animals, four of which had exhibited clinical signs, one was a skin test 'reactor', and three had been seropositive. M. bovis was isolated from seven of these eight animals. Clinical signs combined with serology were found to be useful in identifying infected animals, but tuberculin skin testing had limited negative predictive value as four llamas that were subsequently confirmed as infected were not detected using this assay. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  9. [Standardization of serological tests for Chagas disease: an immunoenzymatic test for blood donors triage].

    PubMed

    Ferreira, A W; Belem, Z R; Moura, M E; Camargo, M E

    1991-01-01

    In the serological diagnosis of Chagas disease large divergences may be found even between laboratories with experience, as a consequence of different criteria for the standardization of the tests. To standardize a immunoenzymatic test developed primarily for screening blood donors, serum panels were carefully chosen so as to best represent chagasic and non-chagasic populations. Produced for the highest sensibility and stability, the new reagent (bioELISA cruzi, Biolab Diagnóstica S/A, Brasil), was tested in serum from 1648 patients 219 with Chagas disease and 104 with other diseases, plus a comparison with well standardized immunofluorescence and hemagglutination tests in 1325 sera. In the immunoenzymatic assays, the cut off was indicated by the absorbance value of a chagasic serum showing a minimal reactivity. ELISA sensibility was 0.9954 and specificity 0.9969, as co-negativity. False positive results were absent with sera from syphilis, toxoplasmosis, mononucleosis and high titered sera for antistreptolysin 0 antibodies. However they were seen in 5 to 15 cases of tegumentar leishmaniasis, 1 of 12 Kala-azar 1 of 15 rheumatoid arthritis and 1 of 12 systemic lupus erythematosus. The high sensibility in chagasics and high specificity in the general population indicate the confiability of the immunoenzymatic assay for screening blood donors and even to confirm a clinical diagnosis of Chagas' disease.

  10. Barriers and missed opportunities to HIV testing among injection drug users in two Mexico – US border cities

    PubMed Central

    MOYER, L. B.; BROUWER, K. C.; BRODINE, S. K.; RAMOS, R.; LOZADA, R.; CRUZ, M. FIRESTONE; MAGIS-RODRIGUEZ, C.; STRATHDEE, S. A.

    2007-01-01

    Introduction and Aims Despite increasing HIV prevalence in cities along the Mexico – US border, HIV testing among high-risk populations remains low. We sought to identify barriers associated with HIV testing among injection drug users (IDUs) in Tijuana and Ciudad Juarez, the two largest Mexican border cities located across from San Diego, California and El Paso, Texas, respectively. Design and Methods In 2005, 222 IDUs in Tijuana and 205 IDUs in Ciudad Juarez were recruited by respondent-driven sampling and administered a questionnaire to collect socio-demographic, behavioural and HIV testing history data. Blood samples were provided for serological testing of HIV, hepatitis C virus (HCV) and syphilis. Results Only 38% and 30% of respondents in Tijuana and Ciudad Juarez, respectively, had ever had an HIV test. The factors associated independently with never having been tested for HIV differed between the two sites, except for lack of knowledge on HIV transmission, which was associated independently in both locales. Importantly, 65% of those who had never been tested for HIV in both cities experienced at least one missed opportunity for voluntary testing, including medical visits, drug treatment and spending time in jail. Discussion and Conclusions Among this high-risk IDU population we found HIV testing to be low, with voluntary testing in public and private settings utilised inadequately. These findings underscore the need to expand voluntary HIV education and testing and to integrate it into services and locales frequented by IDUs in these Mexico –US border cities. PMID:18034380

  11. Barriers and missed opportunities to HIV testing among injection drug users in two Mexico--US border cities.

    PubMed

    Moyer, Laura B; Brouwer, Kimberley C; Brodine, Stephanie K; Ramos, Rebeca; Lozada, Remedios; Cruz, Michelle Firestone; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

    2008-01-01

    Despite increasing HIV prevalence in cities along the Mexico--US border, HIV testing among high-risk populations remains low. We sought to identify barriers associated with HIV testing among injection drug users (IDUs) in Tijuana and Ciudad Juarez, the two largest Mexican border cities located across from San Diego, California and El Paso, Texas, respectively. In 2005, 222 IDUs in Tijuana and 205 IDUs in Ciudad Juarez were recruited by respondent-driven sampling and administered a questionnaire to collect socio-demographic, behavioural and HIV testing history data. Blood samples were provided for serological testing of HIV, hepatitis C virus (HCV) and syphilis. Only 38% and 30% of respondents in Tijuana and Ciudad Juarez, respectively, had ever had an HIV test. The factors independently associated with never having been tested for HIV differed between the two sites, except for lack of knowledge on HIV transmission, which was independently associated in both locales. Importantly, 65% of those who had never been tested for HIV in both cities experienced at least one missed opportunity for voluntary testing, including medical visits, drug treatment and spending time in jail. Among this high-risk IDU population we found HIV testing to be low, with voluntary testing in public and private settings utilised inadequately. These findings underscore the need to expand voluntary HIV education and testing and to integrate it into services and locales frequented by IDUs in these Mexico--US border cities.

  12. Seroprevalence and comparison of different serological tests for brucellosis detection in small ruminants

    PubMed Central

    Sadhu, Dashrath B.; Panchasara, H. H.; Chauhan, H. C.; Sutariya, D. R.; Parmar, V. L.; Prajapati, H. B.

    2015-01-01

    Aim: The aim was to study the seroprevalence and efficacy of the different serological tests used for detection of antibody against Brucella species in small ruminants of Banaskantha district of North-Gujarat. Materials and Methods: Total 1000 serum samples comprising of 485 from sheep and 515 from goat tested for detection of antibodies against the Brucella species by three different serological tests viz., Rose bengal plate test (RBPT), Standard tube agglutination test (STAT), and Indirect Enzyme-linked immunosorbent assay (I-ELISA). Results: The seroprevalence of brucellosis in small ruminants was 11.30%, 11.10%, and 8.80% by RBPT, STAT, and I-ELISA, respectively. The seroprevalence of brucellosis was found to be higher in sheep than goats. The sensitivity of RBPT was found slight more than STAT, but the specificity of both tests was same. In this study, the overall agreement of RBPT and STAT with I-ELISA was found 92.50% and 92.30% in small ruminants, respectively. Conclusion: I-ELISA was a better serological test as compared to RBPT and STAT in the sense of sensitivity, specificity, and rapidity and it could be advocated for screening of brucellosis in sheep and goats. PMID:27047135

  13. Evaluation of Four Whole-Cell Leptospira-Based Serological Tests for Diagnosis of Urban Leptospirosis▿

    PubMed Central

    McBride, Alan J. A.; Santos, Balbino L.; Queiroz, Adriano; Santos, Andréia C.; Hartskeerl, Rudy A.; Reis, Mitermayer G.; Ko, Albert I.

    2007-01-01

    Four serologic assays for leptospirosis had sensitivities of 72 to 88% and specificities of 88 to 100% in the setting of highly endemic urban transmission, indicating that assays using enzyme-linked immunosorbency and rapid formats may be used as alternatives to the microscopic agglutination test for diagnosing urban leptospirosis. Testing a second sample will be required in cases with an initial negative result, since sensitivity was low (46 to 68%) during the first week of illness. PMID:17652521

  14. Reducing the cost of HIV antibody testing.

    PubMed

    Tamashiro, H; Maskill, W; Emmanuel, J; Fauquex, A; Sato, P; Heymann, D

    1993-07-10

    Available tests to detect antibody to human immunodeficiency virus (HIV) have a range of applications, and injudicious selection and inappropriate use can add a significant financial burden to budgets for AIDS programmes in developing countries. There are several ways by which the cost of HIV antibody testing can be reduced; they include use of tests appropriate for existing laboratory capabilities; adoption of cost-effective testing strategies; pooling of serum samples before testing; and ensuring best possible purchase prices. Each approach can significantly reduce the cost of HIV antibody testing alone or in combination, which increases the potential sustainability of antibody testing programmes, even in settings of limited resources.

  15. HIV incidence estimate combining HIV/AIDS surveillance, testing history information and HIV test to identify recent infections in Lazio, Italy

    PubMed Central

    2012-01-01

    Background The application of serological methods in HIV/AIDS routine surveillance systems to identify persons with recently acquired HIV infection has been proposed as a tool which may provide an accurate description of the current transmission patterns of HIV. Using the information about recent infection it is possible to estimate HIV incidence, according to the model proposed by Karon et al. in 2008, that accounts for the effect of testing practices on the number of persons detected as recently infected. Methods We used data from HIV/AIDS surveillance in the period 2004-2008 to identify newly diagnosed persons. These were classified with recent/non-recent infection on the basis of an avidity index result, or laboratory evidence of recently acquired infection (i.e., previous documented negative HIV test within 6 months; or presence of HIV RNA or p24 antigen with simultaneous negative/indeterminate HIV antibody test). Multiple imputation was used to impute missing information. The incidence estimate was obtained as the number of persons detected as recently infected divided by the estimated probability of detection. Estimates were stratified by calendar year, transmission category, gender and nationality. Results During the period considered 3,633 new HIV diagnoses were reported to the regional surveillance system. Applying the model, we estimated that in 2004-2008 there were 5,465 new infections (95%CI: 4,538-6,461); stratifying by transmission category, the estimated number of infections was 2,599 among heterosexual contacts, 2,208 among men-who-have-sex-with-men, and 763 among injecting-drug-users. In 2008 there were 952 (625-1,229) new HIV infections (incidence of 19.9 per 100,000 person-years). In 2008, for men-who-have-sex-with-men (691 per 100,000 person-years) and injecting drug users (577 per 100,000 person-years) the incidence remained comparatively high with respect to the general population, although a decreasing pattern during 2004-2008 was observed

  16. Serological Screening Test for Any Botulinum Toxin Type

    DTIC Science & Technology

    1982-04-01

    1), 400 LD50 of type B toxin (2) and 80 LD50 of type E toxin (3). These botulinum toxin ELISA are based on the " double sandwich" prin- ciple but...antibody for IgG of AT but not of AT 2 1, The double sandwich approach is possible because of multiple antigenic determinants of the toxin molecule... immunodiffusion tests against homologous type antitoxin obtained by injecting a rabbit with toxoid made of a relatively crude toxin sample. All neurotoxins

  17. Accuracy of Herdsmen Reporting versus Serologic Testing for Estimating Foot-and-Mouth Disease Prevalence

    PubMed Central

    Handel, Ian G.; Tanya, Vincent N.; Hamman, Saidou M.; Nfon, Charles; Bergman, Ingrid E.; Malirat, Viviana; Sorensen, Karl J.; Bronsvoort, Barend M. de C.

    2014-01-01

    Herdsman-reported disease prevalence is widely used in veterinary epidemiologic studies, especially for diseases with visible external lesions; however, the accuracy of such reports is rarely validated. Thus, we used latent class analysis in a Bayesian framework to compare sensitivity and specificity of herdsman reporting with virus neutralization testing and use of 3 nonstructural protein ELISAs for estimates of foot-and-mouth disease (FMD) prevalence on the Adamawa plateau of Cameroon in 2000. Herdsman-reported estimates in this FMD-endemic area were comparable to those obtained from serologic testing. To harness to this cost-effective resource of monitoring emerging infectious diseases, we suggest that estimates of the sensitivity and specificity of herdsmen reporting should be done in parallel with serologic surveys of other animal diseases. PMID:25417556

  18. Integrative literature review of the reported uses of serological tests in leprosy management.

    PubMed

    Fabri, Angélica da Conceição Oliveira Coelho; Carvalho, Ana Paula Mendes; Vieira, Nayara Figueiredo; Bueno, Isabela de Caux; Rodrigues, Rayssa Nogueira; Monteiro, Thayenne Barrozo Mota; Correa-Oliveira, Rodrigo; Duthie, Malcolm S; Lana, Francisco Carlos Félix

    2016-04-01

    An integrative literature review was conducted to synthesize available publications regarding the potential use of serological tests in leprosy programs. We searched the databases Literatura Latino-Americana e do Caribe em Ciências da Saúde, Índice Bibliográfico Espanhol em Ciências da Saúde, Acervo da Biblioteca da Organização Pan-Americana da Saúde, Medical Literature Analysis and Retrieval System Online, Hanseníase, National Library of Medicine, Scopus, Ovid, Cinahl, and Web of Science for articles investigating the use of serological tests for antibodies against phenolic glycolipid-I (PGL-I), ML0405, ML2331, leprosy IDRI diagnostic-1 (LID-1), and natural disaccharide octyl-leprosy IDRI diagnostic-1 (NDO-LID). From an initial pool of 3.514 articles, 40 full-length articles fulfilled our inclusion criteria. Based on these papers, we concluded that these antibodies can be used to assist in diagnosing leprosy, detecting neuritis, monitoring therapeutic efficacy, and monitoring household contacts or at-risk populations in leprosy-endemic areas. Thus, available data suggest that serological tests could contribute substantially to leprosy management.

  19. Systematic Serological Testing for Hepatitis E Virus in Kidney Transplant Recipients

    PubMed Central

    Legris, Tristan; Motte, Anne; Vacher-Coponat, Henri; Fages, Lucie; Jourde-Chiche, Noémie; Borentain, Patrick; Jaubert, Dominique; Gerolami, René; Colson, Philippe

    2015-01-01

    Hepatitis E virus (HEV) genotype 3 is endemic in Europe and hyperendemic in southern France. Recent reports of a high prevalence of HEV RNA in blood donations and in culinary specialties from this geographical area confirmed the endemicity of HEV and sources of viral transmission in this geographical area. HEV causes acute and chronic hepatitis in solid organ transplant recipients. Since March 2012, we have implemented systematic HEV serological testing in our cohort of kidney transplant recipients (KTRs) in Marseille in southeastern France. The aim of our study was to assess HEV exposure in this cohort between March 2012 and May 2014. During these 27 months, we found that 39% of the patients who underwent kidney transplantation had an anti-HEV IgG response using a sensitive microplate enzyme immunoassay. This seroprevalence was approximately 43% at both 1 and 8 years after, using the same assay. In addition, systematic HEV serological testing detected 6 cases of HEV infection among 578 KTRs (1%) during the 27 months of the study, with 5 at an acute stage and 1 at a chronic stage. In conclusion, continuous HEV monitoring in this population is useful for better understanding the epidemiology of HEV in France, because these patients are a well-monitored population. Moreover, HEV monitoring in KTRs is clinically relevant because HEV represents a clinical threat in these patients. Nevertheless, HEV serological testing may be more fruitful for identifying HEV infections when performed in cases of biological liver abnormalities than when performed systematically. PMID:25694530

  20. [Sensitivity of the COBAS AmpliScreen™ HIV-1 test v1.5 for HIV-1 detection].

    PubMed

    Gomez, Lucía P; Balangero, Marcos C; Castro, Gonzalo; Kademian, Silvia; Mangeaud, Arnaldo; Barbas, María G; Cudolá, Analía; de León, Juan F; Carrizo, Horacio; Gallego, Sandra V

    2014-01-01

    The introduction of nucleic acid amplification techniques (NAT) in blood banks was intended to reduce the residual risk of transfusion-transmitted infections. Co-circulation of a great diversity of HIV-1 variants in Argentina portrays the need to assess the sensitivity of serological and molecular assays available for their detection. In this study, we evaluated the sensitivity of the COBAS AmpliScreen™ HIV-1 Test, version 1.5 (Roche) for the detection of HIV-1 RNA in plasma samples of infected individuals from Argentina. The results of this study reveal that this technique has high sensitivity for the detection of HIV-1 RNA under assay conditions: using mini-pool testing, pools ≥ 50 RNA copies per ml achieved ≥ 92 % sensitivity, whereas in the standard procedure, samples ≥ 207 RNA copies/ml achieved 100 % sensitivity. Moreover, the COBAS AmpliScreen™ HIV-1 Test, version 1.5 (Roche) is suitable for detecting prevailing HIV-1 variants. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España. All rights reserved.

  1. Relationship of phospholipid chemistry to serological reactivity in the Venereal Disease Research Laboratory slide test antigen.

    PubMed Central

    Reeves, M W; McGrew, B E; McLaurin, B; Pine, L

    1981-01-01

    A total of 13 egg lecithins, 12 beef heart lecithins, and 15 beef heart cardiolipins were assayed for the ability to function in the Venereal Disease Research Laboratory microflocculation test, as well as for purity, fatty acid composition, free amines, metals, and products of oxidation. We found that the presence of peroxides and oxidation-related ultraviolet-absorbing chromophores showed a close inverse relationship to acceptable serological activity. The degree of purity of the lipids had only a slight influence on serological activity, whereas fatty acid composition, saturation, and configuration had none at all. We did not detect contaminating iron, copper, cobalt, nickel, or free amines in these lipids. We discuss the implications of our findings for improving the chemical standards for these lipids. Images PMID:7263853

  2. HIV Testing in the United States

    MedlinePlus

    ... May 2007. ← Return to text FDA Consumer Information, “Fourth Generation HIV Diagnostic Test Approved, permitting earlier detection of infection;” June 2010. ← Return to text FDA Approval Letter, July 3, 2012 Approval Letter, OraQuick In-Home HIV ...

  3. Women's barriers to HIV-1 testing and disclosure: challenges for HIV-1 voluntary counselling and testing.

    PubMed

    Maman, S; Mbwambo, J; Hogan, N M; Kilonzo, G P; Sweat, M

    2001-10-01

    In view of the ever-increasing HIV/AIDS epidemic in sub-Saharan Africa, the expansion of HIV-1 voluntary counselling and testing (VCT) as an integral part of prevention strategies and medical research is both a reality and an urgent need. As the availability of HIV-1 VCT grows two limitations need to be addressed, namely: low rates of HIV-1 serostatus disclosure to sexual partners and negative outcomes of serostatus disclosure. Results from a study among men, women and couples at an HIV-1 VCT clinic in Dar es Salaam, Tanzania are presented. The individual, relational and environmental factors that influence the decision to test for HIV-1 and to share test results with partners are described. The most salient barriers to HIV-1 testing and serostatus disclosure described by women include fear of partners' reaction, decision-making and communication patterns between partners, and partners' attitudes towards HIV-1 testing. Perception of personal risk for HIV-1 is the major factor driving women to overcome barriers to HIV-1 testing. The implications of findings for the promotion of HIV-1 VCT programmes, the implementation of partner notification policies and the development of post-test support services are discussed.

  4. Hepatitis B vaccination uptake and correlates of serologic response among HIV-infected and uninfected men who have sex with men (MSM) in Bangkok, Thailand.

    PubMed

    Chonwattana, Wannee; Raengsakulrach, Boonyos; Holtz, Timothy H; Wasinrapee, Punneeporn; Tongtoyai, Jaray; Chaikummao, Supaporn; Pattanasin, Sarika; McNicholl, Janet M; van Griensven, Frits; Curlin, Marcel E

    2016-04-12

    Vaccination against hepatitis B virus (HBV) is recommended for all HBV-susceptible men who have sex with men (MSM). There is limited information on correlates of immunity to HBV vaccination in this group. We present serologic response rates to hepatitis B vaccine and identify factors associated with impaired response among HIV-uninfected and HIV-infected Thai MSM. HBV-susceptible volunteers were offered hepatitis B vaccination at months zero, one, and six. We measured baseline (pre-vaccination) total serum IgG and IgG subclasses (all participants), baseline CD4 count, and plasma HIV-1 viral load (PVL) (HIV+ participants). HBV serologies were retested at 12 months. Serologic responses were compared between all groups in men receiving three vaccine doses. 511/651 HIV-negative and 64/84 HIV-positive participants completed the three-dose series. Response rates in HIV-uninfected and -infected participants were 90.1% vs. 50.0% (p<0.0001). Median pre-vaccination IgG was higher among non-responders than responders overall (1238.9.0 vs. 1057.0mg/dL, p=0.003) and among HIV-infected participants (1534.0 vs. 1244.5mg/dL, p=0.005), but not significantly among HIV-uninfected participants (1105.5 vs. 1054.3mg/dL, p=0.96). Pre-vaccination IgG1 and IgG3 levels were higher among HIV-positive than HIV-negative participants (median 866.0 vs. 520.3, and 105.8 vs. 83.1mg/dL, respectively, p<0.0001). Among HIV-infected participants, median CD4 count in non-responders was 378 cells/μL vs. 431 cells/μL in responders (p=0.20). Median PVL in non-responders was 64,800 copies/mL vs. 15500 copies/mL in responders (p=0.04). Participants with pre-vaccination plasma IgG >1550 mg/dL and PVL >10,000 copies/mL were almost always non-responsive (p<0.01). HIV infection was associated with poor vaccine responses. High plasma viral load, elevated pre-vaccination total serum IgG and elevated pre-vaccination IgG1 are associated with poorer response to vaccination among HIV-infected MSM. In this group

  5. Indeterminate and discrepant rapid HIV test results in couples' HIV testing and counselling centres in Africa

    PubMed Central

    2011-01-01

    Background Many HIV voluntary testing and counselling centres in Africa use rapid antibody tests, in parallel or in sequence, to establish same-day HIV status. The interpretation of indeterminate or discrepant results between different rapid tests on one sample poses a challenge. We investigated the use of an algorithm using three serial rapid HIV tests in cohabiting couples to resolve unclear serostatuses. Methods Heterosexual couples visited the Rwanda Zambia HIV Research Group testing centres in Kigali, Rwanda, and Lusaka, Zambia, to assess HIV infection status. Individuals with unclear HIV rapid antibody test results (indeterminate) or discrepant results were asked to return for repeat testing to resolve HIV status. If either partner of a couple tested positive or indeterminate with the screening test, both partners were tested with a confirmatory test. Individuals with indeterminate or discrepant results were further tested with a tie-breaker and monthly retesting. HIV-RNA viral load was determined when HIV status was not resolved by follow-up rapid testing. Individuals were classified based on two of three initial tests as "Positive", "Negative" or "Other". Follow-up testing and/or HIV-RNA viral load testing determined them as "Infected", "Uninfected" or "Unresolved". Results Of 45,820 individuals tested as couples, 2.3% (4.1% of couples) had at least one discrepant or indeterminate rapid result. A total of 65% of those individuals had follow-up testing and of those individuals initially classified as "Negative" by three initial rapid tests, less than 1% were resolved as "Infected". In contrast, of those individuals with at least one discrepant or indeterminate result who were initially classified as "Positive", only 46% were resolved as "Infected", while the remainder was resolved as "Uninfected" (46%) or "Unresolved" (8%). A positive HIV serostatus of one of the partners was a strong predictor of infection in the other partner as 48% of individuals who

  6. Inactivation of human immunodeficiency virus (HIV) by ionizing radiation in body fluids and serological evidence

    SciTech Connect

    Bigbee, P.D.; Sarin, P.S.; Humphreys, J.C.; Eubanks, W.G.; Sun, D.; Hocken, D.G.; Thornton, A.; Adams, D.E.; Simic, M.G. )

    1989-11-01

    A method to use ionizing radiation to inactivate HIV (Human Immunodeficiency Virus) in human body fluids was studied in an effort to reduce the risk of accidental infection to forensic science laboratory workers. Experiments conducted indicate that an X-ray absorbed dose of 25 krad was required to completely inactivate HIV. This does not alter forensically important constituents such as enzymes and proteins in body fluids. This method of inactivation of HIV cannot be used on body fluids which will be subjected to deoxyribonucleic acid (DNA) typing.

  7. HIV Testing Rates and Testing Locations, by Race and Ethnicity

    ERIC Educational Resources Information Center

    Rountree, Michele A.; Chen Lynn; Brown Adama; Pomeroy, Elizabeth C.

    2009-01-01

    The purpose of this study is to report the HIV testing rates among white Americans, African Americans, and Hispanic Americans and to identify the frequency of use of HIV testing locations according to a variety of sociodemographic variables. Data for this study came from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). Participants in…

  8. HIV Testing Rates and Testing Locations, by Race and Ethnicity

    ERIC Educational Resources Information Center

    Rountree, Michele A.; Chen Lynn; Brown Adama; Pomeroy, Elizabeth C.

    2009-01-01

    The purpose of this study is to report the HIV testing rates among white Americans, African Americans, and Hispanic Americans and to identify the frequency of use of HIV testing locations according to a variety of sociodemographic variables. Data for this study came from the 2005 Behavioral Risk Factor Surveillance System (BRFSS). Participants in…

  9. Strong serological responses and HIV RNA increase following AS03-adjuvanted pandemic immunization in HIV-infected patients.

    PubMed

    Calmy, A; Bel, M; Nguyen, A; Combescure, C; Delhumeau, C; Meier, S; Yerly, S; Kaiser, L; Hirschel, B; Siegrist, C-A

    2012-04-01

    We aimed to determine the antibody responses and effect on viral load of the AS03-adjuvanted pandemic H1N1 vaccine in HIV-infected patients. A total of 121 HIV-infected patients and 138 healthy subjects were enrolled in a prospective, open-label study. Healthy subjects received one dose and HIV-infected patients two doses of the AS03-adjuvanted split influenza A/09/H1N1 vaccine (Pandemrix®; GlaxoSmithKline, Brentford, United Kingdom.) at an interval of 3-4 weeks. The study was extended in 2010/2011 for 66 patients. Geometric mean titres (GMTs), seroprotection rates (post-vaccination titre ≥ 1:40) and HIV-1 RNA levels were measured before and 4 weeks after immunization. After two immunizations, the seroprotection rate (94.2 vs. 87%, respectively) and GMT (376 vs. 340, respectively) in HIV-infected patients were as high as in healthy subjects after one dose, regardless of CD4 cell count. Four weeks after immunization, HIV RNA was detected in plasma samples from 40 of 68 (58.0%) previously aviraemic patients [median 152 HIV-1 RNA copies/mL; interquartile range (IQR) 87-509 copies/mL]. Subsequent measures indicated that HIV RNA levels had again declined to <20 copies/mL in most patients (27 of 34; 79.4%). Following (nonadjuvanted) influenza immunization in 2010/2011, HIV RNA levels only slightly increased (median final level 28 copies/mL) in three of 66 (4.5%) previously aviraemic patients, including two of 25 (8%) patients in whom an increase had been elicited by AS03-adjuvanted vaccine the year before. Most HIV-infected patients developed seroprotection after two doses of AS03-adjuvanted pandemic vaccine. A transient effect on HIV RNA levels was observed in previously aviraemic patients. A booster dose of the nonadjuvanted influenza vaccine containing the A/09/H1N1 strain the following year did not reproduce this finding, indicating a non-antigen-specific adjuvant effect. © 2011 British HIV Association.

  10. Evaluation of different turkey rhinotracheitis viruses used as antigens for serological testing following live vaccination and challenge.

    PubMed

    Eterradossi, N; Toquin, D; Guittet, M; Bennejean, G

    1995-05-01

    Two enzyme-linked immunosorbent assays (ELISA) developed in the authors' laboratory for turkey rhinotracheitis serological testing, a commercial ELISA kit, and two virus-neutralization (VN) assays were compared with respect to the efficiency of these assays for serological monitoring in specific-pathogen-free (SPF) turkeys inoculated with four pathogenic isolates of turkey rhinotracheitis virus, with or without previous live vaccination. Both the live vaccine and the different isolates of virus were shown to induce antibody rises, the detectability of which varied depending on the ELISA or VN assay used for serological testing. The results show that 3 weeks after vaccination with an attenuated strain, the choice of an inadequate antigen for serological testing may be the cause of an apparent lack of immunogenicity of the vaccine, and that 2 weeks after challenge, such a choice in ELISA can also hinder the early diagnosis of a TRT virus infection in both vaccinated and unvaccinated turkeys.

  11. Rapid diagnostic tests duo as alternative to conventional serological assays for conclusive Chagas disease diagnosis.

    PubMed

    Egüez, Karina E; Alonso-Padilla, Julio; Terán, Carolina; Chipana, Zenobia; García, Wilson; Torrico, Faustino; Gascon, Joaquim; Lozano-Beltran, Daniel-Franz; Pinazo, María-Jesús

    2017-04-01

    Chagas disease is caused by the parasite Trypanosoma cruzi. It affects several million people, mainly in Latin America, and severe cardiac and/or digestive complications occur in ~30% of the chronically infected patients. Disease acute stage is mostly asymptomatic and infection goes undiagnosed. In the chronic phase direct parasite detection is hampered due to its concealed presence and diagnosis is achieved by serological methods, like ELISA or indirect hemagglutination assays. Agreement in at least two tests must be obtained due to parasite wide antigenic variability. These techniques require equipped labs and trained personnel and are not available in distant regions. As a result, many infected people often remain undiagnosed until it is too late, as the two available chemotherapies show diminished efficacy in the advanced chronic stage. Easy-to-use rapid diagnostic tests have been developed to be implemented in remote areas as an alternative to conventional tests. They do not need electricity, nor cold chain, they can return results within an hour and some even work with whole blood as sample, like Chagas Stat-Pak (ChemBio Inc.) and Chagas Detect Plus (InBIOS Inc.). Nonetheless, in order to qualify a rapidly diagnosed positive patient for treatment, conventional serological confirmation is obligatory, which might risk its start. In this study two rapid tests based on distinct antigen sets were used in parallel as a way to obtain a fast and conclusive Chagas disease diagnosis using whole blood samples. Chagas Stat-Pak and Chagas Detect Plus were validated by comparison with three conventional tests yielding 100% sensitivity and 99.3% specificity over 342 patients seeking Chagas disease diagnosis in a reference centre in Sucre (Bolivia). Combined used of RDTs in distant regions could substitute laborious conventional serology, allowing immediate treatment and favouring better adhesion to it.

  12. Counselling about HIV serological status disclosure: nursing practice or law enforcement? a Foucauldian reflection.

    PubMed

    O'Byrne, Patrick; Holmes, Dave; Roy, Marie

    2015-06-01

    Recently, focus groups and qualitative interviews with nurses who provide frontline care for persons living with HIV highlighted the contentiousness surrounding the seemingly innocuous activity of counselling clients about HIV-status disclosure, hereafter disclosure counselling. These empirical studies highlighted that while some nurses felt they should instruct clients to disclose their HIV-positive status if HIV transmission were possible, other nurses were equally adamant that such counselling was outside the nursing scope of practice. A review of these opposing perceptions about disclosure counselling, including an examination of the empirical evidence which supports each point, revealed that the dichotomous arguments needed to be nuanced. The empirical evidence about serostatus disclosure neither supported nor refuted either of these assertions; rather, it substantiated parts of each. To create this understanding, both empirical and theoretical works are used. First, the results of empirical studies about serostatus disclosure, or lack thereof and HIV transmission is presented; as part of this, Marks and Crepaz's HIV disclosure and exposure framework is examined. Second, the work of Michel Foucault on disciplinary and pastoral power is drawn from. The outcome is a nuanced understanding about the interrelationships between disclosure counselling and nursing practice and a final interpretation about what this understanding means for public health practice.

  13. Assessment of serological tests for the diagnosis of canine visceral leishmaniasis.

    PubMed

    da Silva, Denise Amaro; Madeira, Maria de Fátima; Abrantes, Tuanne Rotti; Filho, Carlos José de Lima Barbosa; Figueiredo, Fabiano Borges

    2013-02-01

    An immunoenzymatic assay (ELISA), an indirect immunofluorescence antibody test (IFAT) with different antigens (ELISA-Leishmania chagasi, ELISA-L. major-like, IFAT-L. chagasi and IFAT-L. major-like), and an immunochromatographic test were assessed for the diagnosis of canine visceral leishmaniasis (CVL). Serum samples from 144 dogs from an endemic area for visceral leishmaniasis in the municipality of Rio de Janeiro were tested. The sensitivities of the serological tests were 93%, 100%, 73%, 60% and 93%, with specificities of 87%, 92%, 77%, 96% and 92% for the ELISA-L. major-like, ELISA-L. chagasi, IFAT-L. major-like, IFAT-L. chagasi and the immuno chromatographic test, respectively. ELISA-L. chagasi was the best test for the diagnosis of CVL, but the immunochromatographic test could be a useful alternative as it offers simple and rapid diagnosis without the need for a specialized laboratory. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Evaluation of three serological tests manufactured in Belarus for the diagnosis of syphilis.

    PubMed

    Shimanskaya, Iryna; Zhurauskaya, Larisa; Pankratov, Oleg; Unemo, Magnus; Ballard, Ronald C; Domeika, Marius

    2011-05-01

    The performance of three serological tests manufactured in Belarus for the diagnosis of syphilis, i.e. a microprecipitation reaction (MPR) and two enzyme-linked immunosorbent assays (ELISAs) were compared with internationally recognized assays, namely the rapid plasma reagin test and the Treponema pallidum passive particle agglutination assay (TPPA). Sera from 392 consecutive patients attending Brest (Belarus) regional dermatovenereological dispensaries were tested. The sensitivity of the MPR test was low (77.3%) compared with the rapid plasma reagin test, while the specificity was high (100%). In contrast, both Belarusian ELISAs performed well when compared with the TPPA (sensitivities of 99.2% and 100%, specificities of 98.7% and 99.0%, respectively). There is a clear need to improve the sensitivity of the existing Belarusian MPR test or to use a more sensitive screening test in order to improve diagnosis of the disease in Belarus.

  15. HIV: seek, test, treat, and retain.

    PubMed

    Normand, Jacques; Montaner, Julio; Fang, Chi-Tai; Wu, Zunyou; Chen, Yi-Ming

    2013-12-01

    The "HIV: Seek, Test, Treat, and Retain" session was chaired by Dr. Jacques Normand, the Director of AIDS Research at the U.S. National Institute on Drug Abuse. Dr. Yi-Ming Chen served as the discussant. The three presenters (and their presentation topics) were: Dr. Julio Montaner (Treatment as Prevention-The Key to an AIDS-free Generation), Dr. Chi-Tai Fang (Population-level Effect of Free Access to HAART on Reducing HIV Transmission in Taiwan), and Dr. Zunyou Wu (Challenges in Promoting HIV Test & Treat Strategy in China).

  16. HIV testing in women: missed opportunities.

    PubMed

    Duffus, Wayne A; Davis, Harley T; Byrd, Michael D; Heidari, Khosrow; Stephens, Terri G; Gibson, James J

    2012-02-01

    To investigate opportunities for early human immunodeficiency virus (HIV) testing of women. A retrospective cohort study design linked case reports from HIV surveillance to several statewide health-care databases. Medical encounters occurring before the first positive HIV test (missed opportunities) were categorized by diagnosis/procedure codes to distinguish visits that were likely to have prompted an HIV test. Women were categorized as late testers (AIDS diagnosis <12 months from first HIV test date), non-late testers (no AIDS diagnosis during study period or diagnosis of AIDS >12 months of HIV diagnosis), of reproductive age (13-44 years old), and not of reproductive age (>44 years old). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were used to estimate risk and its statistical significance. Of 3303 HIV-infected women diagnosed during the study period, 2408 (73%) had missed opportunity visits. Late testers (39%) were more likely to be black than white (aOR 1.48, 95% CI 1.12-1.95), be older (>44 years old; aOR 7.85, 95% CI 4.49-13.7), and have >10 missed opportunity visits (aOR 2.17, 95% CI 1.62-2.91). Fifty-four percent of women >44 years old were also late testers. Women >44 years old had lower median initial CD4 counts (p<0.001). The top two procedures were the same for all groups of women but mammography was ranked fourth for women >44 years old and Papanicolau smear was ranked fourth for late testers. Feasibility and acceptability of routine HIV testing in nontraditional health-care settings, such as mammography and Papanicolau screenings, should be explored to identify late testers and older (not of reproductive age) HIV-infected women.

  17. Seroprevalence of antibodies to measles, mumps, and rubella, and serologic responses after vaccination among human immunodeficiency virus (HIV)-1 infected adults in Northern Thailand.

    PubMed

    Chaiwarith, Romanee; Praparattanapan, Jutarat; Nuket, Khanuengnit; Kotarathitithum, Wilai; Supparatpinyo, Khuanchai

    2016-04-30

    After the global implementation of national immunization programs for prevention of measles, mumps, and rubella (MMR), the prevalences of protective antibodies to these viruses are high in general population. However, there are limited data among human immunodeficiency virus (HIV)-1 infected individuals. This study aimed to determine the seroprevalence of antibodies to these viruses, and the serologic responses after vaccination among HIV-infected adults in Northern Thailand. A cross-sectional study was conducted in 500 HIV-infected adults, aged 20-59 years, receiving combination antiretroviral therapy, CD4 cell count ≥200 cells/mm(3), and plasma HIV-1 RNA <50 copies/mL, and 132 HIV-uninfected controls, aged 20-59 years, at Chiang Mai University Hospital during July and August 2011. Prevalences of protective antibodies to these viruses as well as serologic responses after MMR vaccination in those without protective antibody to at least one of the three viruses were compared between groups. The prevalences of protective antibodies to measles, mumps, and rubella were 94.2, 55.0, and 84.6 % among HIV-infected adults, and 97.7, 67.5, and 89.4 % among HIV-uninfected controls, respectively. The prevalence of protective antibody to mumps was significantly lower in HIV-infected adults (p-value = 0.010). MMR vaccination was done in 249 HIV-infected and 46 HIV-uninfected controls; at week 8 to 12 after vaccination, the seroprotective rates against measles, mumps, and rubella in HIV-infected adults were 96.4, 70.7, and 98.0 %, respectively, whereas those in HIV-uninfected controls were 100, 87, and 100 %, respectively. No serious adverse effects were observed. In contrast to measles and rubella, the prevalence of protective antibody to mumps was low in both HIV-infected adults and HIV-uninfected controls in northern Thailand. The seroprotective rates after MMR vaccination in both groups were considerably high, except only for mumps. Therefore, MMR vaccination

  18. Serological Diagnosis of Acute Scrub Typhus in Southern India: Evaluation of InBios Scrub Typhus Detect IgM Rapid Test and Comparison with other Serological Tests.

    PubMed

    Anitharaj, Velmurugan; Stephen, Selvaraj; Pradeep, Jothimani; Park, Sungman; Kim, Seung-Han; Kim, Young Jin; Kim, Eun-Ye; Kim, Yoon-Won

    2016-11-01

    Scrub Typhus (ST) is being reported from different parts of India in the recent past. However, the diagnosis and confirmation of ST cases require specific serological and molecular diagnostic tests. Both rapid and conventional ELISA tests need to be properly evaluated. Evaluation of a new ST IgM Immunochromatography (ICT) test kit (InBios Scrub Typhus Detect IgM Rapid Test) and compare it with another rapid kit, conventional ELISA kit and Weil-Felix (WF) test. This prospective study was carried out in Mahatma Gandhi Medical College and Research Institute, Puducherry, during November 2015 to June 2016. Clinically suspected 220 ST patients were examined by a new kit, InBios Scrub Typhus Detect IgM Rapid Test, taking the conventional InBios Scrub Typhus Detect IgM ELISA as reference. Additional comparison was made with ImmuneMed Scrub Typhus Rapid, and WF test (single OXK titers ≥1:320). Statistical analysis was performed (Chi-square, Spearman's correlation and Kappa) using IBM SPSS Statistics 17 for Windows (SPSS Inc; Chicago, USA). Percentage Sensitivity, Specificity, Positive Predictive and Negative Predictive Values for InBios, ImmuneMed and WF were 99.25, 93.02, 95.68, 98.77; 94.87, 94.19, 96.21, 92.05 and 50.38, 95.51, 94.29, 56.67 respectively. A total of 134 patients were positive in reference standard InBios IgM ELISA. This new rapid ST IgM kit validated for the first time in India, showed good sensitivity and specificity. As a Point-of-Care (PoC) test, the kit would be helpful in both urban and remote rural parts of India.

  19. Serological Diagnosis of Acute Scrub Typhus in Southern India: Evaluation of InBios Scrub Typhus Detect IgM Rapid Test and Comparison with other Serological Tests

    PubMed Central

    Anitharaj, Velmurugan; Pradeep, Jothimani; Park, Sungman; Kim, Seung-Han; Kim, Young Jin; Kim, Eun-Ye; Kim, Yoon-Won

    2016-01-01

    Introduction Scrub Typhus (ST) is being reported from different parts of India in the recent past. However, the diagnosis and confirmation of ST cases require specific serological and molecular diagnostic tests. Both rapid and conventional ELISA tests need to be properly evaluated. Aim Evaluation of a new ST IgM Immunochromatography (ICT) test kit (InBios Scrub Typhus Detect IgM Rapid Test) and compare it with another rapid kit, conventional ELISA kit and Weil-Felix (WF) test. Materials and Methods This prospective study was carried out in Mahatma Gandhi Medical College and Research Institute, Puducherry, during November 2015 to June 2016. Clinically suspected 220 ST patients were examined by a new kit, InBios Scrub Typhus Detect IgM Rapid Test, taking the conventional InBios Scrub Typhus Detect IgM ELISA as reference. Additional comparison was made with ImmuneMed Scrub Typhus Rapid, and WF test (single OXK titers ≥1:320). Statistical analysis was performed (Chi-square, Spearman’s correlation and Kappa) using IBM SPSS Statistics 17 for Windows (SPSS Inc; Chicago, USA). Results Percentage Sensitivity, Specificity, Positive Predictive and Negative Predictive Values for InBios, ImmuneMed and WF were 99.25, 93.02, 95.68, 98.77; 94.87, 94.19, 96.21, 92.05 and 50.38, 95.51, 94.29, 56.67 respectively. A total of 134 patients were positive in reference standard InBios IgM ELISA. Conclusion This new rapid ST IgM kit validated for the first time in India, showed good sensitivity and specificity. As a Point-of-Care (PoC) test, the kit would be helpful in both urban and remote rural parts of India. PMID:28050364

  20. Performance of rapid tests and algorithms for HIV screening in Abidjan, Ivory Coast.

    PubMed

    Loukou, Y G; Cabran, M A; Yessé, Zinzendorf Nanga; Adouko, B M O; Lathro, S J; Agbessi-Kouassi, K B T

    2014-01-01

    Seven rapid diagnosis tests (RDTs) of HIV were evaluated by a panel group who collected serum samples from patients in Abidjan (HIV-1 = 203, HIV-2 = 25, HIV-dual = 25, HIV = 305). Kit performances were recorded after the reference techniques (enzyme-linked immunosorbent assay). The following RDTs showed a sensitivity of 100% and a specificity higher than 99%: Determine, Oraquick, SD Bioline, BCP, and Stat-Pak. These kits were used to establish infection screening strategies. The combination with 2 or 3 of these tests in series or parallel algorithms showed that series combinations with 2 tests (Oraquick and Bioline) and 3 tests (Determine, BCP, and Stat-Pak) gave the best performances (sensitivity, specificity, positive predictive value, and negative predictive value of 100%). However, the combination with 2 tests appeared to be more onerous than the combination with 3 tests. The combination with Determine, BCP, and Stat-Pak tests serving as a tiebreaker could be an alternative to the HIV/AIDS serological screening in Abidjan.

  1. [Serological investigation of Toxoplasma gondii infection in HIV positive cases in Dali and Dehong of Yunnan].

    PubMed

    You, Ying-Xia; Li, Wei; Shen, Li-Jie; Nie, Da-Ping

    2012-10-30

    Serum samples were collected from HIV positive cases (927) and HIV, negative ones (80) from June 2010 to August 2011 in Dali and Dehong Prefectures of Yunnan. Serum anti-Toxoplasma gondii IgG was detected by ELISA. The overall anti-Toxoplasma gondii IgG positive rate among HIV positive cases and HIV negative ones was 35.1% (325/927) and 23.8% (19/80), respectively. In HIV positive cases, the seropositive rate was 30.3% (178/588) in Dali and 43.4% (147/339) in Dehong. The seropositive rate was significantly different among ethnic groups (chi2 = 28.433, P < 0.05). No significant difference was found among age groups (chi2 = 4.248, P > 0.05), and the age group of 41-60 showed the highest positive rate (36.1%, 103/285). The seropositive rate was 35.6% (203/571) in males and 34.3% (122/356) in females (chi2 = 0.158, P > 0.05).

  2. Serological, intradermal and live flea challenge tests in the assessment of hypersensitivity to flea antigens in cats (Felis domesticus).

    PubMed

    Bond, Ross; Hutchinson, Melanie J; Loeffler, Anette

    2006-09-01

    The results of intradermal testing with three commercial flea antigens and a serological test for IgE antibodies to flea antigens were compared with live flea challenge in cats. Eight control cats with no prior flea exposure had negative serological test and flea challenge results. By contrast, 17 out of 27 cats with previous flea exposure showed immediate reactivity to flea challenge; reactivity at 6, 24 and 48 h after flea exposure was noted in 12, 16 and 21 cats, respectively. Seventeen of these cats had positive serological test results. Seven cats showed immediate intradermal test reactions to the ARTU allergen, six reacted to the Biophady allergen, and six reacted to the Greer allergen. Intradermal test reactivity was less frequent at the other time points. Using the results of the flea challenge as the 'gold standard' for the presence or absence of sensitisation to fleas, the sensitivity and specificity of the serological test was 0.88 and 0.77, respectively. Sensitivities of the intradermal tests at the four time points ranged from 0 to 0.33, whereas the specificities ranged from 0.78 to 1.0. Live flea challenge is better able to detect cats with hypersensitivity to fleas than either intradermal or serological testing.

  3. Comparison of a recombinant-antigen enzyme immunoassay with Treponema pallidum hemagglutination test for serological confirmation of syphilis.

    PubMed

    Rodríguez, Islay; Alvarez, Elvio L; Fernández, Carmen; Miranda, Alina

    2002-04-01

    A recombinant-antigen enzyme immunoassay (EIA), BioSCREEN anti-Treponema pallidum, was compared favorably with the T. pallidum hemagglutination test, in the detection of specific antibodies in different groups of sera from patients with primary (n = 38), secondary (n = 10), early latent (n = 28) and congenital syphilis (n = 2), patients with leptospirosis ( n= 8), infectious mononucleosis (n = 7), hepatitis (n = 9), diabetes mellitus (n = 11), rheumatoid arthritis (n = 13), leprosy (n = 11), tuberculosis (n = 9), HIV/Aids ( n= 12), systemic lupus erythematosus (n = 4), rheumatic fever (n = 3), old-persons (n = 9), pregnant women (n = 29) and blood donors (n = 164). The coincidence between them was 95.1%. The sensitivity and specificity of the EIA were 93.3% and 95.5%, respectively. Fifteen serum specimens belonging to old-persons, pregnant women, blood donors, and patients with human leptospirosis, hepatitis, diabetes mellitus, tuberculosis and rheumatic fever gave false-positive results by Venereal Disease Research Laboratory and/or Rapid Plasma Reagin. The EIA can be used as alternative method for the serological confirmation of syphilis.

  4. HIV antibody testing in young, urban adults.

    PubMed

    Berrios, D C; Hearst, N; Perkins, L L; Burke, G L; Sidney, S; McCreath, H E; Hulley, S B

    1992-02-01

    We surveyed men and women aged 21 to 34 years to determine the rates of human immunodeficiency virus (HIV) antibody testing in blacks and whites of diverse education levels in four US cities. Responses to the anonymous, mailed questionnaire were received from 90% of 777 white women, 64% of 734 black women, 79% of 677 white men, and 48% of 541 black men. The percentages reporting HIV testing for these four race-gender groups were 29%, 22%, 30%, and 38%, respectively. The percentages reporting testing that was voluntarily sought (ie, not in connection with blood donation, military service) were 16%, 14%, 18%, and 22%, respectively. In each race-gender group, roughly half of those who had not been tested said they "might have a blood test for the AIDS virus in the future". Education level was not correlated with HIV-testing frequency. Blacks were significantly less likely than whites to be aware of "a blood test that can detect the AIDS virus infection" (58% vs 77%), but blacks who knew of the test were more likely than whites to have been tested (47% vs 37%). Eleven percent of subjects reported at least one major risk factor for HIV infection. In these people, HIV testing was most common among homosexually active men (56% tested; 52% voluntarily sought), intermediate among injection drug users (40% tested; 31% voluntarily sought), and least common among the sexual partners of injection-drug users (21% tested; 11% voluntarily sought). Health education programs need to communicate the availability of, and need for, anonymous HIV testing.

  5. Using HIV Sequence and Epidemiologic Data to Assess the Effect of Self-referral Testing for Acute HIV Infection on Incident Diagnoses in San Diego, California.

    PubMed

    Mehta, Sanjay R; Murrell, Ben; Anderson, Christy M; Kosakovsky Pond, Sergei L; Wertheim, Joel O; Young, Jason A; Freitas, Lorri; Richman, Douglas D; Mathews, W Chris; Scheffler, Konrad; Little, Susan J; Smith, Davey M

    2016-07-01

    Because recently infected individuals disproportionately contribute to the spread of human immunodeficiency virus (HIV), we evaluated the impact of a primary HIV screening program (the Early Test) implemented in San Diego. The Early Test program used combined nucleic acid and serology testing to screen for primary infection targeting local high-risk individuals. Epidemiologic, HIV sequence, and geographic data were obtained from the San Diego County Department of Public Health and the Early Test program. Poisson regression analysis was performed to determine whether the Early Test program was temporally and geographically associated with changes in incident HIV diagnoses. Transmission chains were inferred by phylogenetic analysis of sequence data. Over time, a decrease in incident HIV diagnoses was observed proportional to the number primary HIV infections diagnosed in each San Diego region (P < .001). Molecular network analyses also showed that transmission chains were more likely to terminate in regions where the program was marketed (P = .002). Although, individuals in these zip codes had infection diagnosed earlier (P = .08), they were not treated earlier (P = .83). These findings suggests that early HIV diagnoses by this primary infection screening program probably contributed to the observed decrease in new HIV diagnoses in San Diego, and they support the expansion and evaluation of similar programs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  6. Using HIV Sequence and Epidemiologic Data to Assess the Effect of Self-referral Testing for Acute HIV Infection on Incident Diagnoses in San Diego, California

    PubMed Central

    Mehta, Sanjay R.; Murrell, Ben; Anderson, Christy M.; Kosakovsky Pond, Sergei L.; Wertheim, Joel O.; Young, Jason A.; Freitas, Lorri; Richman, Douglas D.; Mathews, W. Chris; Scheffler, Konrad; Little, Susan J.; Smith, Davey M.

    2016-01-01

    Background. Because recently infected individuals disproportionately contribute to the spread of human immunodeficiency virus (HIV), we evaluated the impact of a primary HIV screening program (the Early Test) implemented in San Diego. Methods. The Early Test program used combined nucleic acid and serology testing to screen for primary infection targeting local high-risk individuals. Epidemiologic, HIV sequence, and geographic data were obtained from the San Diego County Department of Public Health and the Early Test program. Poisson regression analysis was performed to determine whether the Early Test program was temporally and geographically associated with changes in incident HIV diagnoses. Transmission chains were inferred by phylogenetic analysis of sequence data. Results. Over time, a decrease in incident HIV diagnoses was observed proportional to the number primary HIV infections diagnosed in each San Diego region (P < .001). Molecular network analyses also showed that transmission chains were more likely to terminate in regions where the program was marketed (P = .002). Although, individuals in these zip codes had infection diagnosed earlier (P = .08), they were not treated earlier (P = .83). Conclusions. These findings suggests that early HIV diagnoses by this primary infection screening program probably contributed to the observed decrease in new HIV diagnoses in San Diego, and they support the expansion and evaluation of similar programs. PMID:27174704

  7. Serological findings in leprosy and tuberculosis with the Wassermann, Meinicke, and VDRL tests

    PubMed Central

    Ruge, H.

    1955-01-01

    In the course of a venereal disease survey in Egypt, 820 cases of leprosy and 720 cases of tuberculosis were serologically examined with the Wassermann, Meinicke (MKR II), and VDRL tests; the results are reported in this paper. On serological and anamnestic evidence, 31 cases of syphilis were discovered among the leprosy cases and 37 among the tuberculosis cases. Apparently false positive reactions were seen in 203 cases of leprosy (25%) and in 38 cases of tuberculosis (5%). The author discusses the probability that a fairly high proportion of these reactions were in fact caused by otherwise undetected syphilis or were non-specific. The Meinicke test proved the most specific of the three, followed, in that order, by the Wassermann and the VDRL tests. It was found that syphilis was more frequent among males with tuberculosis than among those with leprosy; this is attributed to the fact that leprosy patients are kept in greater isolation. Less easily explicable is the fact that more females than males with leprosy were found to have syphilis, whereas in tuberculous persons the difference in syphilis incidence between male and female patients was not very great. PMID:13284561

  8. Ethical implications of HIV self-testing.

    PubMed

    Youngs, Jonathan; Hooper, Carwyn

    2015-10-01

    In April 2015, the first legally approved HIV self-testing kit went on sale in the UK-except Northern Ireland where they remain illegal. These tests allow individuals to test their HIV status and read the result in the privacy of their own home, much like a home pregnancy test. This paper explores the ethical implications of HIV self-testing. We conclude that there are no strong ethical objections to self-testing being made widely available in the UK. Pretest counselling for an HIV test is not an ethical necessity, and self-testing has the potential to increase early diagnosis of HIV infection and thus improve prognosis and reduce ongoing transmission. Self-testing kits might also empower people and promote autonomy by allowing people to dictate the terms on which they test their HIV status. We accept that there are some potential areas of concern. These include the possibility of user error with the tests, and the concern that individuals may not present to health services following a reactive result. False negatives have the potential to cause harm if the 'window period' is not understood, and false positives might produce psychological distress. There is, however, little evidence to suggest that self-testing kits will cause widespread harm, and we argue that the only way to properly evaluate whether they do cause significant harm is to carefully evaluate their use, now that they are available on the market. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Comparative Study of Serological Tests for Mycoplasma synoviae Diagnosis in Commercial Poultry Breeders

    PubMed Central

    Luciano, R. L.; Cardoso, A. L. S. P.; Stoppa, G. F. Z.; Kanashiro, A. M. I.; de Castro, A. G. M.; Tessari, E. N. C.

    2011-01-01

    Avian mycoplasmosis causes great economic losses to the poultry industry, and one of the major agents involved is Mycoplasma synovie (MS). Serum from commercial poultry breeders (n = 2781) was tested for MS by serum plate agglutination (SPA), hemagglutination inhibition (HI), and enzyme-linked immunosorbent assay (ELISA). From 2,781 samples tested, 736 (26.46%) were positive in SPA. From 712 SPA-positive sera, 30 samples (4.21%) were positive in HI, and 150 samples (21.06%) were positive in ELISA. Copositivity between ELISA and HI was 90%, and conegativity was 82.0%. Agreement between HI and ELISA was rejected by McNemar's test (P ≤ .001), and Kappa coefficient showed a weak correlation between the two techniques (k = 0.25; 0.21 ≤ k < 0.40). Weak statistical correlation was observed between all serological tests (SPA, HI, and ELISA), and they should only be used for initial screening for MS. PMID:21547263

  10. Assessment of milk ring test and some serological tests in the detection of Brucella melitensis in Syrian female sheep.

    PubMed

    Al-Mariri, Ayman; Ramadan, Lila; Akel, Rand

    2011-04-01

    Brucella melitensis infection prevalence among Syrian female sheep, to evaluate a number of serological tests and to discuss some epidemiological aspects of brucellosis, was studied. A total of 2,580 unvaccinated Syrian female sheep sera samples were tested for B. melitensis antibodies detection using four serological methods: the Rose Bengal test (RBT), the serum agglutination test (SAT), the complement fixation test (CFT) and an indirect enzyme-linked immunosorbent assay (iELISA). In addition, 2,375 milk samples were collected, then milk ring test (MRT) and bacterial isolation test were employed to evaluate the natural organism shedding. The samples were considered positive in 66%, 64%, and 60% when we employed the RBT, SAT, and iELISA tests, respectively. Whereas, the CFT test revealed the smallest number of positive samples. By using the MRT, the total prevalence of brucellosis was nearly 38% of samples. A large variation was observed concerning the studied areas, ranging from 24% in Tartous to 44% in both Damascus and Damascus rural areas. Brucella was isolated from only 677 samples out of the 2,375 female sheep milk samples.

  11. Using HIV resistance tests in clinical practice.

    PubMed

    Taylor, Stephen; Jayasuriya, Ashini; Smit, Erasmus

    2009-08-01

    Genotypic resistance testing is now a standard of care in HIV management. Although there are clear, published guidelines to recommend the appropriate use of these tests, clinicians and scientists still struggle to determine the optimal use of resistance tests given the finite budgets and time constraints under which they work. In this article we discuss some 'real-life' clinical situations and aim to provide a useful insight into when and where genotypic resistance testing can be optimally applied in the management of HIV-positive adults.

  12. HIV Testing among College Students.

    ERIC Educational Resources Information Center

    Hitchcock, Daryl L.; And Others

    An increase of human immunodeficiency virus (HIV) throughout the world cuts across age, ethnic, gender, and sexual orientation groups. It is imperative that people find out if they are carrying the disease. Many still continue to engage in high risk behaviors in ignorance, putting themselves and their partners at risk. The relationships among fear…

  13. Seroprevalence of human brucellosis in and around Jammu, India, using different serological tests

    PubMed Central

    Sharma, H. K.; Kotwal, S. K.; Singh, D. K.; Malik, M. A.; Kumar, Arvind; Rajagunalan; Singh, M.

    2016-01-01

    Aim: Brucellosis is a disease of zoonotic importance as it affects both human as well as animal’s health, and therefore, directly affects animal productivity and human efficiency. Therefore, a study was conducted to estimate the seroprevalence of brucellosis in humans in Jammu and surrounding areas. Materials and Methods: A total of 121 sera samples from humans occupied with professional related to animals were collected and tested for anti-Brucella antibodies by Rose Bengal plate test (RBPT), modified RBPT (mRBPT), standard tube agglutination test (STAT), and indirect enzyme-linked immunosorbent assay (I-ELISA). Sampling was done keeping in view with the occupation, sex, and age. Results: The overall seroprevalence of brucellosis recorded was 4.96%. The test-wise seroprevalence was 9.91% by RBPT, 9.91% by mRBPT, 9.09% by STAT, and 16.52% by I-ELISA. The prevalence of brucellosis was higher in >35-50 years age group compared to >20-35 years and >50-65 years. Sex-wise seroprevalence was higher in males than females. Taking I-ELISA as standard, the relative sensitivities of mRBPT, RBPT, and I-ELISA were in the order of mRBPT=RBPT>STAT. All the tests revealed high specificity values; however, among different serological tests, I-ELISA detected a maximum number of positive sera samples. Conclusions: The prevalence of brucellosis was found to be approximately 5%. The adult (>35-50 years) age male group was most vulnerable. The routine diagnosis of brucellosis involved the conventional serological tests, viz., RBPT and STAT, but each was associated with drawbacks which could give either false-positive or false-negative interpretation. Therefore, it is always recommended to use a battery of tests in the diagnosis of brucellosis. PMID:27536036

  14. Evaluation of serological tests for diagnosis of Brucella melitensis infection of goats.

    PubMed Central

    Díaz-Aparicio, E; Marín, C; Alonso-Urmeneta, B; Aragón, V; Pérez-Ortiz, S; Pardo, M; Blasco, J M; Díaz, R; Moriyón, I

    1994-01-01

    Five serological assays were evaluated for the diagnosis of brucellosis in goats: the rose bengal test (RBT), complement fixation test (CFT), radial immunodiffusion (RID) with Brucella and Yersinia enterocolitica O:9 polysaccharides, counterimmunoelectrophoresis (CIEP) with cytosol, and enzyme-linked immunosorbent assay (ELISA) with polyclonal and protein G conjugates and smooth lipopolysaccharide (S-LPS), native hapten polysaccharide (NH), or cytosol antigens. For optimal sensitivity, RBT had to be used with sera-antigen at a 3:1 dilution. In the RID test, Brucella melitensis biotype 1 NH could not be replaced by Brucella abortus biotype 1 or Y. enterocolitica 0:9 polysaccharides. In the ELISA, S-LPS and NH gave similar results and the protein G conjugate increased the specificity. With the sera from 55 B. melitensis culture-positive goats, the sensitivity was 100% for RBT, CFT (titer > or = 4), and ELISA with S-LPS or NH; 94% for RID; and 93% for CIEP. All tests were negative (100% specific) when testing the sera from 127 brucella-free goats. Larger discrepancies among the results of the serological tests were obtained with sera from goats of areas where brucellosis is endemic. When the sera of 20 young goats vaccinated subcutaneously (10(9) CFU of B. melitensis Rev 1) and bled 6 months later were examined, the specificities were as follows: NH ELISA, 60%; CFT and S-LPS ELISA, 75%; RBT, 80%; CIEP, 90%; and RID, 94%. With the sera from 10 young goats vaccinated conjunctivally (10(9) CFU of B. melitensis Rev 1) all tests were 100% specific 4 months after vaccination. The proportion of goats giving a positive reaction after vaccination decreased faster in RID than in other tests. PMID:8051240

  15. RhCE protein variants in Southwestern Germany detected by serologic routine testing

    PubMed Central

    Bugert, Peter; Scharberg, Erwin A.; Geisen, Christof; von Zabern, Inge; Flegel, Willy A.

    2017-01-01

    BACKGROUND Variant RHCE alleles with diminished expression of C, c, E, and e antigens have been described and indicate the genetic diversity of this gene locus in several populations. In this study the molecular background of variant RhCE antigens identified by standard serologic routine testing in German blood donors and patients was determined. STUDY DESIGN AND METHODS Samples from blood donors and patients were routinely analyzed for RhCE phenotype using the PK7200 analyzer with two sets of monoclonal anti-C, -c, -E, and -e reagents. Samples with confirmed variant RhCE antigens were analyzed by nucleotide sequencing of the 10 RHCE exons. A multiplex polymerase chain reaction with sequence-specific priming (PCR-SSP) method was established for rapid typing of the rare RHCE alleles. RESULTS We identified 43 samples with serologic RhCE variants. Molecular analysis revealed variant RHCE alleles in 34 samples. Altogether 22 RHCE alleles were detected; 10 have not been published before. Twenty alleles harbored distinct single-nucleotide substitutions, 18 of which encoded amino acid changes and 2 of which occurred in noncoding regions. Two samples represented RHCE-D-CE hybrid alleles involving different segments of the RHCE Exon 5. A multiplex PCR-SSP screening for 17 RHCE alleles was negative in 1344 samples of the DNA bank GerBS. The cumulative phenotype frequency was estimated between 1 in 488 (0.20%) and 1 in 8449 (0.012%). CONCLUSION Single-amino-acid substitutions were the molecular basis for variant RhCE antigen expression in most samples. Nucleotide substitutions in RHCE exons were excluded as possible mechanism of diminished RhCE antigen expression in one-fifth of the serologically identified samples. PMID:19453980

  16. Consequences of HIV testing without consent.

    PubMed

    Obi, Samuel N; Ifebunandu, Ngozi A

    2006-02-01

    The objective of this study is to explore the HIV-infected individuals' experience with HIV testing, counselling, disclosure of diagnosis and subsequent life events following diagnosis. The method used is a questionnaire survey of 340 consecutive HIV-positive victims, seen in two health institutions in southeast Nigeria within a one-year-period, November 2003 to October 2004. Three hundred and twenty respondents answered the questionnaire, 121 were men and 199 women, with 79% in the age range 20-39 years. Most respondents had known their HIV status for 3.2 (+/-1.1) years and the majority are in the lower social class. About 80% reported that their consent for HIV test was not asked for, resulting in feelings of fear, disbelief, shock and embarrassment on learning about their HIV status. Despite the initial reaction to the diagnosis, majority (81.9%) expressed satisfaction with the pattern of disclosure of diagnosis. There was some reluctance to inform spouse/partner of the diagnosis especially among asymptomatic, unmarried, childless or divorced victims. A serodiscordant couple resulted in mistrust and increased incidence of abandonment. Apart from spouse/partner the respondents are more likely to inform their siblings of the diagnosis than parents, children or friends. Despite being supportive, the respondents are more likely to suffer more neglect from siblings than their spouse (P<0.05) but the risk of being abandoned was more with the spouse than with siblings (P<0.05). Only 32.6% of the 129 respondents on antiretroviral therapy are regular with it mainly because of cost and non-availability of drugs. Default in treatment was more evident among the unmarried, those with low educational status and treatment with antiretroviral drugs for more than two years. Proper pre- and post-test counselling, promotion of behavioural change among the society about HIV/AIDS and provision of support and cost-effective care for HIV victims is advocated.

  17. Sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays or HIV RNA tests.

    PubMed

    Tan, Wei Sheng; Chow, Eric P F; Fairley, Christopher K; Chen, Marcus Y; Bradshaw, Catriona S; Read, Tim R H

    2016-07-31

    Determine the sensitivity of HIV rapid tests compared with fourth-generation enzyme immunoassays (EIA) or nucleic acid amplification tests (NAAT) in clinical settings. Systematic review and meta-analysis. Medline, PubMed, Embase, Cochrane Controlled Trials Register, Cochrane reviews and Cumulative Index to Nursing and Allied Health Literature were searched until 14 July 2015 for studies of adults comparing point-of-care HIV rapid tests to fourth-generation HIV EIA antibody/p24 antigen or HIV NAAT. From 953 titles, 18 studies were included, involving 110 122 HIV rapid test results. Compared with EIA, the estimated sensitivity (random effects) of HIV rapid tests was 94.5% [95% confidence interval (CI): 87.4-97.7]. Compared with NAAT, the sensitivity of HIV rapid tests was 93.7% (95% CI: 88.7-96.5). The sensitivity of HIV rapid tests in high-income countries was 85.7% (95% CI: 81.9-88.9) and in low-income countries was 97.7% (95% CI: 95.2-98.9) compared with either EIA or NAAT (P < 0.01 for difference between settings). Proportions of antibody negative acute infections were 13.6 (95% CI: 10.1-18.0) and 4.7% (95% CI: 2.8-7.7) in studies from high-income and low-income countries, respectively (P < 0.01). In clinical settings, HIV rapid tests were less sensitive in high-income countries compared with low-income countries, missing about one in seven infections, possibly because of the larger proportion of acute infections in targeted populations. This suggests that in high-income countries, HIV rapid tests should be used in combination with fourth-generation EIA or NAAT tests, except in special circumstances. Prospective Registration of Systematic Reviews registration number CRD42015020154.Supplementary video link: http://links.lww.com/QAD/A924.

  18. Comparison of counter-immunoelectrophoresis with other serological tests in the diagnosis of human brucellosis

    PubMed Central

    Díaz, R.; Maravi-Poma, E.; Rivero, A.

    1976-01-01

    Sera from 65 persons with clinical brucellosis were employed in a comparison of standard and rapid serological tests. The results obtained with the Rose Bengal test correlated very well with those of the standard tube agglutination test, whereas results with the rapid plate agglutination test and the Coombs (antiglobulin) test were inferior. Absorption of patients' sera with specific anti-human immunoglobulin sera showed that IgM was active in the Rose Bengal test but not in the Coombs test, whereas IgG and IgA were active in both tests. In addition to the A & M antigen, which plays the most important role in the agglutination, Rose Bengal, and Coombs tests, other antigenic fractions of Brucella were examined in precipitation tests. A protein antigen reacted with 94% of the sera in counter-immunoelectrophoresis. On the basis of the results with both groups of sera, the Rose Bengal test and counter-immunoelectrophoresis appear to be the most promising methods for diagnosing clinical brucellosis. The tests differ qualitatively since different Brucella antigens are employed. PMID:791532

  19. Evaluating the validity of the serologic test for detecting Helicobacter pylori infection in Mongolian gerbils.

    PubMed

    Kuo, Chao-Hung; Yu, Fang-Jung; Tsai, Pei-Yun; Yang, Sheau-Fang; Chang, Lin-Li; Jan, Chang-Ming; Wang, Wen-Ming; Wu, Deng-Chyang

    2007-11-01

    A strong correlation between Helicobacter pylori infection and gastric cancer has been reported. Mongolian gerbils are regarded as the most suitable animal model in which to study carcinogenesis associated with H. pylori. The aim of our study was to evaluate the accuracy of the serologic test for detecting H. pylori infection in Mongolian gerbils. The model was developed as follows: the H. pylori colony (vacuolating cytotoxin A (+)/cytotoxin-associated gene A (+)) was cultured from the mucosas of previously H. pylori-fed gerbils. These colonies were cultured in broth. Then,we fed the gerbils with 0.5-1 mL of broth (about 10(9) CFU/mL) (intragastric administration) twice within a 3-day period. After inoculation for 6 or 26 weeks, the gerbils were sacrificed and their gastric mucosas were sampled for a series of examinations. Blood samples for serologic testing (STAT-PAK) were collected. H. pylori infection was confirmed. Statistical analysis was performed using the Chi-square test. Differences were regarded as significant when the p value was less than 0.05. A total of 50 gerbils were inoculated with H. pylori and the success rate reached 88%. All 10 gerbils in the control group showed a negative result. Damage to the mucosas was more obvious following increasing periods of inoculation. The rates of sensitivity and specificity, as determined by the STAT-PAK test, were 90.9% and 100%, respectively. The positive and negative predictive values were 100% and 60%, respectively. The STAT-PAK test seemed to be more sensitive and accurate (p < 0.05) in high H. pylori densities. In conclusion, the STAT-PAK test (blood-sampling) showed acceptable results and was suitable for long-term observation of H. pylori infection.

  20. Prick-tests and serological tests in the diagnosis of allergic reactivity to enzymes used in washing products

    PubMed Central

    How, M. J.; Cambridge, G. W.

    1971-01-01

    How, M. J., and Cambridge, G. W. (1971).Brit. J. industr. Med.,28, 303-307. Prick-tests and serological tests in the diagnosis of allergic reactivity to enzymes used in washing products. Standardized prick-test antigens for use in the detection of allergic reactivity to enzymes (Alcalase and Maxatase) used in washing products have been prepared. These materials contained all the potentially allergenic components of the crude enzyme preparations. Tests showed that these materials were more appropriate, as prick-test antigens, than the crystalline enzyme. The presence of reagin-mediated, immediate-type allergy in factory workers was confirmed by prick-tests and passive transfer tests. Sera from these subjects and controls contained enzyme-specific haemagglutinating antibody and gave precipitin-like reactions with solutions of Alcalase and Maxatase. The latter reaction involved serum components electrophoretically similar to, or identical with, α-globulins. PMID:4997564

  1. Antibody testing and counseling of dental patients at risk for human immunodeficiency virus (HIV) infection and associated clinical findings.

    PubMed

    Murrah, V A; Scholtes, G A

    1988-10-01

    Two hundred six dental patients were tested between 1985 and 1987 for antibodies to human immunodeficiency virus (HIV) when a review of their medical histories revealed a high risk for infection. Serologic results are correlated with soft tissue and osseous findings recorded during routine head and neck and radiographic examination. Counseling recommendations for use in association with testing are outlined. A more active role for the dentist as a preventive agent is advocated to combat the spread of acquired immunodeficiency syndrome (AIDS).

  2. Rapid diagnosis in serology.

    PubMed

    García-Bermejo, Isabel; de Ory, Fernando

    2017-04-01

    Serological diagnosis of acute phase infections implies the detection of IgM specific response, an effective marker of primary infection, but with less clinical significance in reactivations or reinfections. The aim of this article is to provide an updated view of the rapid diagnosis in serology by detecting the IgM isotype and reviewing its applications and limitations. Point-of-care (PoC) tests are analyzed. PoC tests are used in geographical areas where traditional tests are not available, as well as in other circumstances where their use brings the diagnosis directly to the target population. Likewise, their use reduces the response time between taking the sample and the diagnosis, making it easier to make clinical decisions. PoC assays have proven cost-effective, especially in preventing vertical transmission of syphilis and HIV infection. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  3. Serological Testing Versus Other Strategies for Diagnosis of Active Tuberculosis in India: A Cost-Effectiveness Analysis

    PubMed Central

    Dowdy, David W.; Steingart, Karen R.; Pai, Madhukar

    2011-01-01

    Background Undiagnosed and misdiagnosed tuberculosis (TB) drives the epidemic in India. Serological (antibody detection) TB tests are not recommended by any agency, but widely used in many countries, including the Indian private sector. The cost and impact of using serology compared with other diagnostic techniques is unknown. Methods and Findings Taking a patient cohort conservatively equal to the annual number of serological tests done in India (1.5 million adults suspected of having active TB), we used decision analysis to estimate costs and effectiveness of sputum smear microscopy (US$3.62 for two smears), microscopy plus automated liquid culture (mycobacterium growth indicator tube [MGIT], US$20/test), and serological testing (anda-tb ELISA, US$20/test). Data on test accuracy and costs were obtained from published literature. We adopted the perspective of the Indian TB control sector and an analysis frame of 1 year. Our primary outcome was the incremental cost per disability-adjusted life year (DALY) averted. We performed one-way sensitivity analysis on all model parameters, with multiway sensitivity analysis on variables to which the model was most sensitive. If used instead of sputum microscopy, serology generated an estimated 14,000 more TB diagnoses, but also 121,000 more false-positive diagnoses, 102,000 fewer DALYs averted, and 32,000 more secondary TB cases than microscopy, at approximately four times the incremental cost (US$47.5 million versus US$11.9 million). When added to high-quality sputum smears, MGIT culture was estimated to avert 130,000 incremental DALYs at an incremental cost of US$213 per DALY averted. Serology was dominated by (i.e., more costly and less effective than) MGIT culture and remained less economically favorable than sputum smear or TB culture in one-way and multiway sensitivity analyses. Conclusions In India, sputum smear microscopy remains the most cost-effective diagnostic test available for active TB; efforts to increase

  4. Serological testing versus other strategies for diagnosis of active tuberculosis in India: a cost-effectiveness analysis.

    PubMed

    Dowdy, David W; Steingart, Karen R; Pai, Madhukar

    2011-08-01

    Undiagnosed and misdiagnosed tuberculosis (TB) drives the epidemic in India. Serological (antibody detection) TB tests are not recommended by any agency, but widely used in many countries, including the Indian private sector. The cost and impact of using serology compared with other diagnostic techniques is unknown. Taking a patient cohort conservatively equal to the annual number of serological tests done in India (1.5 million adults suspected of having active TB), we used decision analysis to estimate costs and effectiveness of sputum smear microscopy (US$3.62 for two smears), microscopy plus automated liquid culture (mycobacterium growth indicator tube [MGIT], US$20/test), and serological testing (anda-tb ELISA, US$20/test). Data on test accuracy and costs were obtained from published literature. We adopted the perspective of the Indian TB control sector and an analysis frame of 1 year. Our primary outcome was the incremental cost per disability-adjusted life year (DALY) averted. We performed one-way sensitivity analysis on all model parameters, with multiway sensitivity analysis on variables to which the model was most sensitive. If used instead of sputum microscopy, serology generated an estimated 14,000 more TB diagnoses, but also 121,000 more false-positive diagnoses, 102,000 fewer DALYs averted, and 32,000 more secondary TB cases than microscopy, at approximately four times the incremental cost (US$47.5 million versus US$11.9 million). When added to high-quality sputum smears, MGIT culture was estimated to avert 130,000 incremental DALYs at an incremental cost of US$213 per DALY averted. Serology was dominated by (i.e., more costly and less effective than) MGIT culture and remained less economically favorable than sputum smear or TB culture in one-way and multiway sensitivity analyses. In India, sputum smear microscopy remains the most cost-effective diagnostic test available for active TB; efforts to increase access to quality-assured microscopy should

  5. Performances of HTLV serological tests in diagnosing HTLV infection in high-risk population of São Paulo, Brazil.

    PubMed

    Jacob, Fabrício; Santos-Fortuna, Elizabeth de los; Azevedo, Raymundo Soares; Caterino-de-Araujo, Adele

    2007-01-01

    Testing problems in diagnosing human T-lymphotropic virus (HTLV) infection, mostly HTLV-II, have been documented in HIV/AIDS patients. Since December 1998, the Immunology Department of Instituto Adolfo Lutz (IAL) offers HTLV-I/II serology to Public Health Units that attend HTLV high-risk individuals. Two thousand, three hundred and twelve serum samples: 1,393 from AIDS Reference Centers (Group I), and 919 from HTLV out-patient clinics (Group II) were sent to IAL for HTLV-I/II antibodies detection. The majority of them were screened by two enzyme immunoassays (EIAs), and confirmed by Western Blot (WB 2.4, Genelabs). Seven different EIA kits were employed during the period, and according to WB results, the best performance was obtained by EIAs that contain HTLV-I and HTLV-II viral lysates and rgp21 as antigens. Neither 1st and 2nd, nor 3rd generation EIA kits were 100% sensitive in detecting truly HTLV-I/II reactive samples. HTLV-I and HTLV-II prevalence rates of 3.3% and 2.5% were detected in Group I, and of 9.6% and 3.6% in Group II, respectively. High percentages of HTLV-seroindeterminate WB sera were detected in both Groups. The algorithm testing to be employed in HTLV high-risk population from São Paulo, Brazil, needs the use of two EIA kits of different formats and compounds as screening, and because of high seroindeterminate WB, may be another confirmatory assay.

  6. Evaluation of five serological tests for the diagnosis of porcine brucellosis in French Polynesia.

    PubMed

    Praud, Anne; Gimenez, Olivier; Zanella, Gina; Pozzi, Nathalie; Antras, Valérie; Meyer, Laurence; Garin-Bastuji, Bruno

    2013-04-01

    Porcine brucellosis due to Brucella suis biovar 1 raises important issues for pig breeders in French Polynesia. In this region, the disease is enzootic, spreads silently and engenders economic losses in infected farms as well as sporadic human cases. While serological tests are essential in surveillance and control programmes of animal diseases, to date none of the available tests have been shown to be reliable enough to be used as a gold standard in routine individual diagnosis of porcine brucellosis. Few studies about the estimation of the sensitivity and the specificity of porcine brucellosis screening tests have been published, none of them dealing with French Polynesia. The studied population included 1,595 pigs from French Polynesia. Five tests were evaluated: Rose Bengal test, fluorescence polarisation assay, indirect ELISA, and two competitive ELISAs (C-ELISA). The sensitivity and the specificity of each test were estimated. C-ELISA2 was the most sensitive test (Se C-ELISA2=0.954 [0.889; 0.992] 95% credibility interval (CrI)) while both C-ELISA and Rose Bengal test (RBT) were the most specific ones (Sp C-ELISA1=0.856 [0.806; 0.915] 95% CrI; Sp C-ELISA2=0.849 [0.817; 0.879] 95% CrI; Sp RBT=0.853 [0.812; 0.898] 95% CrI).

  7. Adjunctive Tests for Diagnosis of Tuberculosis: Serology, ELISPOT for Site-Specific Lymphocytes, Urinary Lipoarabinomannan, String Test, and Fine Needle Aspiration

    PubMed Central

    Lawn, Stephen D.; Moosa, Mahomed-Yunus S.; Wright, Colleen A.; Kasprowicz, Victoria O.

    2011-01-01

    The diagnostic gold standard for active tuberculosis (TB) is the detection of Mycobacterium tuberculosis (MTB) by culture or molecular methods. However, despite its limited sensitivity, sputum smear microscopy is still the mainstay of TB diagnosis in resource-limited settings. Consequently, diagnosis of smear-negative pulmonary and extrapulmonary TB remains challenging in such settings. A number of novel or alternative techniques could provide adjunctive diagnostic use in the context of difficult-to-diagnose TB. These may be especially useful in certain patient groups such as persons infected with human immunodeficiency virus (HIV) and children, who are disproportionably affected by smear-negative and extrapulmonary disease and who are also most adversely affected by delays in TB diagnosis and treatment. We review a selection of these methods that are independent of nucleic acid amplification techniques and could largely be implemented in resource-limited settings in current or adapted versions. Specifically, we discuss the diagnostic use and potential of serologic tests based on detection of antibodies to MTB antigens; interferon gamma release assays using site-specific lymphocytes; detection of lipoarabinomannan, a glycolipid of MTB, in urine; the string test, a novel technique to retrieve lower respiratory tract samples; and fine needle aspiration biopsy of lymph nodes. PMID:21996695

  8. Serological diagnosis of canine leishmaniosis: comparison of three commercially available tests.

    PubMed

    Wolf, Denis; Failing, Klaus; Taubert, Anja; Pantchev, Nikola

    2014-05-01

    Quantitative serology is an important tool in canine leishmaniosis diagnostics from clinical and epidemiological points of view. Serologic diagnosis in laboratories is traditionally carried out by immunofluorescent antibody test (IFAT), but enzyme-linked immunosorbent assays (ELISA) are being increasingly employed. Two commercially available ELISAs (LEISHMANIA-ELISA DOG® [LED] and INGEZIM LEISHMANIA® [IL]) for the detection of Leishmania infantum infection in dogs were compared with the classical IFAT technique. Ninety-two canine serum samples covering a broad range of IFAT titers were chosen for evaluation. Titers ranged from negative (<1:50) to high (>1:3,200). Statistical analysis showed high correlation between all three assays for both negative and positive IFAT-tested samples as described by respective Spearman's rank correlation coefficient (r s), but results varied for samples with inconclusive IFAT titers (1:50-1:100) with IL stating samples predominantly negative. The highest accordance was found between LED and IFAT (percentage of identical results = 83.7%; r(s) = 0.90, p < 0.0001). IL showed higher analogy with LED (accordance = 81.5%; r(s )= 0.88, p < 0.0001) than with IFAT (73.9%; r(s) = 0.80, p < 0.0001). The distribution of the different ELISA scores is discussed and grouped according to correspondent IFAT titers to familiarize practitioners with the range of these tests since antibody levels play an important role in clinical management of canine patients with L. infantum infection.

  9. HIV testing week 2015: lowering barriers for HIV testing among high-risk groups in Amsterdam.

    PubMed

    Bartelsman, M; Joore, I K; van Bergen, J E; Hogewoning, A A; Zuure, F R; van Veen, M G

    2017-08-01

    Evaluation of the HIV Testing Week (HTW) 2015 in Amsterdam: the number of (positive) tested persons, characteristics and testing history of the tested population, the differences in attendance per location and the healthcare workers' experiences and opinions concerning the HTW. The HTW took place from 28 November till 4 December 2015. Anonymous HIV rapid testing (INSTI™ HIV1/HIV2 Ab test or Determine™ HIV-1/2 Ag/Ab test) was offered free of charge at four hospitals, 12 general practitioner (GP) clinics, a sexually transmitted infections (STI) clinic, a laboratory, sites of a community-based organisation, and at outreach locations. Home-based testing (OraQuick® In-Home HIV Test) was offered online. The focus was to motivate two groups to test: men who have sex with men (MSM) and non-Western migrants. Questionnaires regarding participant's characteristics and HIV testing history were collected. Also healthcare workers were asked to complete a questionnaire evaluating the HTW. In total, 1231 participants were tested. With three positive HIV tests, the detection rate was 0.3% (95%CI 0.26-0.37). Of all participants, 24.7% (304/1231) were MSM. Respectively, 22.3% (275/1231) and 15.7% (193/1231) were first- and second-generation migrants from a non-Western country. Altogether, 56.7% (698/1231) of participants belonged to one of the targeted risk groups. For 32.7% (402/1231) of participants, it was the first time they received testing, and 35.1% (432/1231) were tested more than 1 year ago. Among MSM 13.2% were tested for the first time, among first- and second-generation non-Western migrants this percentage was significantly higher at 27.2% and 33.5% respectively (p < 0.01). The number of tested participants per location varied widely, especially between GP clinics (range 3-63). Healthcare workers were positive about the HTW: about half (46.2%) stated they would more readily offer an HIV test following their experience with the HTW. This was the first time the

  10. From prenatal HIV testing of the mother to prevention of sexual HIV transmission within the couple.

    PubMed

    Desgrées-du-Loû, Annabel; Brou, Hermann; Traore, Annick Tijou; Djohan, Gerard; Becquet, Renaud; Leroy, Valeriane

    2009-09-01

    The first step in preventing mother-to-child HIV transmission (PMTCT) programmes is offering HIV counselling and testing to pregnant women. In developing countries where HIV testing remains rare, it represents a unique opportunity for many women to learn their HIV status. This prenatal HIV testing is not only the entry point to prevention of mother-to-child HIV transmission, but also an occasion for women to sensitize their male partner to sexual risks. Here we explore if these women, HIV-tested as mothers, apply the prevention recommendations they also receive as women. In the Ditrame Plus PMTCT program in Abidjan, Côte d'Ivoire, two cohorts of women (475 HIV-infected women and 400 HIV-negative women) were followed up two years after the pregnancy when they were offered prenatal HIV testing. In each cohort, we compared the proportion of women who communicated with their regular partner on sexual risks, prior to and after prenatal HIV testing. We analysed socio-demographic factors related to this communication. We measured two potential conjugal outcomes of women HIV testing: the level of condom use at sex resumption after delivery and the risk of union break-up. Prenatal HIV testing increased conjugal communication regarding sexual risks, whatever the woman's serostatus. This communication was less frequent for women in a polygamous union or not residing with their partner. Around 30% of women systematically used condoms at sex resumption. Among HIV infected ones, conjugal talk on sexual risks was related to improved condom use. After HIV testing, more HIV-infected women separated from their partners than HIV-uninfected women, despite very few negative reactions from the notified partners. In conclusion, offering prenatal HIV counselling and testing is an efficient tool for sensitizing women and their partners to HIV prevention. But sexual prevention in a conjugal context remains difficult and need to be specifically addressed.

  11. Genomic detection of human immunodeficiency virus (HIV) by nucleic acid amplification test in a frequent platelet donor during the pre-seroconversion period.

    PubMed

    Pondé, Robério Amorim de Almeida

    2011-11-01

    Since serological donor-screening tests for HIV were introduced in 1985, the safety of donated blood components has improved dramatically. However, these tests do not completely prevent the risk of transfusion-associated HIV infection related to the use of blood donated during the pre-seroconversion window period. Testing based on nucleic acid amplification is being implemented to screen for HIV-infected blood donated during this period, which has reduced the probability of transmitting HIV through transfusion by shortening the window period. This article describes a case of acute HIV-1 infection, detected using a nucleic acid amplification test (NAT) in a repeat blood donor who donated during the pre-seroconversion window period and whose antigen and anti-HIV antibody expression was observed after molecular marker detection. In addition, the possible route of infection is discussed based on the patient's history, and finally, the need for NAT technology for blood donor screening is emphasized.

  12. HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually Active Homeless Men?

    ERIC Educational Resources Information Center

    Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

    2012-01-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

  13. HIV Risk Behavior and Access to Services: What Predicts HIV Testing among Heterosexually Active Homeless Men?

    ERIC Educational Resources Information Center

    Wenzel, Suzanne L.; Rhoades, Harmony; Tucker, Joan S.; Golinelli, Daniela; Kennedy, David P.; Zhou, Annie; Ewing, Brett

    2012-01-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV…

  14. Clinical Utility of Serologic Testing for Celiac Disease in Asymptomatic Patients

    PubMed Central

    2011-01-01

    Executive Summary Objective The objective of this evidence-based analysis was to evaluate the clinical utility of serologic testing for celiac disease in asymptomatic individuals presenting with one of the non-gastrointestinal conditions evaluated in this report. The clinical utility was based on the effects of a gluten-free diet (GFD) on outcomes specific to each of these conditions. The prevalence of celiac disease in asymptomatic individuals and one of these non-gastrointestinal conditions was also evaluated. Clinical Need and Target Population Celiac Disease Celiac disease is an autoimmune disease characterized by a chronic inflammatory state of the proximal small bowel mucosa accompanied by structural and functional changes. Technology Under Evaluation Serologic Tests for Celiac Disease There are a number of serologic tests for celiac disease available. Serologic tests are automated with the exception of the anti-endomysial antibody test, which is more time-consuming and operator-dependent than the other tests. Research Questions What is the prevalence of asymptomatic celiac disease in patients presenting with one of the non-gastrointestinal conditions evaluated? What is the effect of the gluten-free diet on condition-specific outcomes in patients with asymptomatic celiac disease presenting with one of the non-gastrointestinal conditions evaluated? What is the clinical utility of serologic testing for celiac disease in asymptomatic patients presenting with one of the non-gastrointestinal conditions evaluated? The clinical utility was defined as the impact of the GFD on disease specific outcomes. What is the risk of all-cause mortality and lymphoma in individuals with asymptomatic celiac disease? What is the budget impact of serologic testing for celiac disease in asymptomatic subjects presenting with one of the non-gastrointestinal conditions evaluated? Research Methods Study Population The study population consisted of individuals with newly diagnosed celiac

  15. HIV Testing Services in Africa: Are They Sustainable?

    PubMed

    Marum, Elizabeth; Conkling, Martha; Kanyanda, Jabez; Gandi, Sheila Birungi; Byaruhanga, Raymond; Alwano, Mary Grace

    2016-10-01

    HIV testing services (HTS) are an essential component of a national response to the HIV epidemic, and in lower and middle income countries, at least 150 million persons are tested annually. HIV testing is necessary to identify persons in need of antiretroviral treatment, which has been documented to be highly effective not only for treatment but also for prevention of HIV transmission to both adults and children. An assessment of the recent literature on sustainability of health and HIV services suggests that organizational performance, flexibility, and integration with other health interventions contribute to sustainability of HIV services and programs. This article describes the experiences of two HIV testing service providers in Uganda and Zambia as well as the track record of services to prevent mother-to-child HIV transmission to illustrate the factors of performance, flexibility, adaptability, and integration which are key to the sustainability of HIV testing services.

  16. Collaborative study for the validation of serological methods for potency testing of diphtheria toxoid vaccines - extended study: correlation of serology with in vivo toxin neutralisation.

    PubMed

    Sesardic, D; Winsnes, R; Rigsby, P; Behr-Gross, M-E

    2004-01-01

    Phase I of BSP034 collaborative study was extended in two laboratories to include correlation of serology with in vivo toxin neutralisation test (TNT) using 2 separate sets of 20 serum pools, produced in-house. The study investigated the extent to which the in vitro methods for diphtheria antibodies, Vero cell assay and diphtheria enzyme-linked immunosorbent assay for diphtheria antitoxin (D-ELISA), can detect neutralising antibodies by comparison with TNT in guinea pigs. The study was also performed to compare the antibody neutralising potency obtained in relation to guinea pig (GP) or equine (DI) antitoxin standard. In addition, the study provided an opportunity to compare ELISA for tetanus antitoxin (T-ELISA) and TNT assay for detection of anti-tetanus antibodies, from the same set of serum pools. The data obtained show that antitoxin potency obtained by Vero cell assay, D-ELISA and T-ELISA using the same GP standard, highly correlated with neutralising potency as determined in respective TNT assays. Vero cell assay with DI provided estimates that also correlated with neutralising potency, but were of significantly lower titre. Since reference to DI standard is widely used in serodiagnosis, as well as in clinical studies where diphtheria antitoxin titres obtained in the Vero cell method are taken as surrogate markers for vaccine efficacy, it should be investigated if a similar difference is also observed for human serology.

  17. Preferred HIV testing services and programme characteristics among clients of a rapid HIV testing programme

    PubMed Central

    2013-01-01

    Background In the current context of diversity and coexistence of HIV testing approaches, limited information exists on test recipient’s views of HIV testing services and programme attributes that could ease the testing process and make it more appealing for at risk individuals who don’t know their HIV status. This study analyzed ratings given to different testing sites and programme characteristics that might facilitate testing. Methods We analyzed data from 3120 persons attending a mobile HIV testing programme located on a central street in the gay district of Madrid. Results 64% were men (of which, 55% had had sex with other men), 59.5% were <30 years, 35.4% foreigners, 50.6% had a university degree,71.7% a regular employment, 59.3% reported multiple partners and inconsistent condom use and 56.5% had been tested for HIV. Non Governmental Organizations and specific HIV/STI centres received the maximum rating from over 60% of participants, followed by self-testing (38.9%). Pharmacies (20.8%) and hospital emergency departments (14.2%) were the worst valued testing sites. Over 80% gave the highest rating to having immediate test results, not needing a previous appointment, and free testing, while less than 50% gave the maximum rating to privacy and anonymity. Conclusions HIV testing services that don’t require an appointment, based on free tests with rapid results are most valued by a young, not socially marginalized but high risk sexual exposure population. On the contrary, issues traditionally highly valued by health care providers or AIDS social organizations (privacy and anonymity) are much less valued. PMID:23987230

  18. Virginia expands HIV testing, licenses viatical firms.

    PubMed

    1997-05-02

    Virginia Governor George Allen signed H.B. 2174, H.B. 871, and S.B. 788 on March 25, 1997. The legislation expands HIV testing of criminal defendants, requires viatical settlement companies to obtain licenses, and imposes civil penalties for physician-assisted suicides.

  19. Prenatal HIV tests. Routine testing or informed choice?

    PubMed Central

    Guenter, Dale; Kaczorowski, Janusz; Carroll, June; Sellors, John

    2003-01-01

    OBJECTIVE: To examine how prenatal care providers responded to a new provincial policy of offering HIV testing to all prenatal patients, and to determine factors associated with self-reported high testing rates. DESIGN: Cross-sectional mailed survey. SETTING: Outpatient practices in three Ontario health-planning regions. PARTICIPANTS: Prenatal care providers: 784 family physicians, 200 obstetricians, and 103 midwives were sent questionnaires and were eligible to participate. MAIN OUTCOME MEASURES: Self-reported testing of 80% or more prenatal patients ("high testers") and associated practice characteristics, attitudes, and counseling practices. RESULTS: Response rate was 57% (622/1087): 43% of respondents were high testers. Family physicians were most likely and midwives least likely to be high testers. High testers tended to report that they had adequate knowledge of HIV testing, that HIV risk among their patients warranted testing all of them, and that testing should be routine. Encouraging women to test and not providing written information or choice were independently associated with high testing rates. CONCLUSION: Strongest predictors of high prenatal HIV testing rates were attitudes and practices that favoured a routine approach to testing and that placed little emphasis on informed consent. PMID:14594102

  20. Sensitivity and specificity of parallel or serial serological testing for detection of canine Leishmania infection.

    PubMed

    Arruda, Mauro Maciel de; Figueiredo, Fabiano Borges; Marcelino, Andreza Pain; Barbosa, José Ronaldo; Werneck, Guilherme Loureiro; Noronha, Elza Ferreira; Romero, Gustavo Adolfo Sierra

    2016-03-01

    In Brazil, human and canine visceral leishmaniasis (CVL) caused by Leishmania infantum has undergone urbanisation since 1980, constituting a public health problem, and serological tests are tools of choice for identifying infected dogs. Until recently, the Brazilian zoonoses control program recommended enzyme-linked immunosorbent assays (ELISA) and indirect immunofluorescence assays (IFA) as the screening and confirmatory methods, respectively, for the detection of canine infection. The purpose of this study was to estimate the accuracy of ELISA and IFA in parallel or serial combinations. The reference standard comprised the results of direct visualisation of parasites in histological sections, immunohistochemical test, or isolation of the parasite in culture. Samples from 98 cases and 1,327 noncases were included. Individually, both tests presented sensitivity of 91.8% and 90.8%, and specificity of 83.4 and 53.4%, for the ELISA and IFA, respectively. When tests were used in parallel combination, sensitivity attained 99.2%, while specificity dropped to 44.8%. When used in serial combination (ELISA followed by IFA), decreased sensitivity (83.3%) and increased specificity (92.5%) were observed. Serial testing approach improved specificity with moderate loss in sensitivity. This strategy could partially fulfill the needs of public health and dog owners for a more accurate diagnosis of CVL.

  1. Equine lentivirus, comparative studies on four serological tests for the diagnosis of equine infectious anaemia.

    PubMed

    Bürki, F; Rossmanith, W; Rossmanith, E

    1992-11-01

    Serological diagnosis of equine infectious anemia is of necessity group-reactive, i.e. based on viral core protein p26, because viral envelope components as well as the host's immune response to them undergo rapid antigenic change. Since 1970 the agar gel-immunodiffusion test ("Coggins-test") has been the diagnostic method of choice. Recently, ELISA tests have been introduced for faster and theoretically more sensitive serodiagnosis, while Western blots have been used to clarify doubtful results obtained in Coggins-tests. A commercial competitive ELISA was found to give practically equivalent results to the Coggins-test. The sensitivity of this market product is intentionally kept marginal in order to avoid false-positive "reactor horses". Another commercial ELISA, non-competitive, gave inconsistent results, creating great turmoil among horse owners when falsely positive. Caution is also indicated when interpreting Western blots. Sera of strongly positive horses gave as many as eleven bands, of medium positives fewer bands, and of the weakest reactors solely the p26 band. Single p26 banding was, however, also encountered in 5% healthy horses, in two of them consistently over time, which are accordingly considered non-specific. In order to be interpreted as positive, a Western blot for this equine lentivirus must band with its core protein plus at least one glycoprotein, similar to the recommended criterion for a positive reading of serum samples from AIDS patients.

  2. Value of serological testing for diagnosis of legionellosis in outbreak patients.

    PubMed

    Rojas, Almudena; Navarro, M Dolores; Fornés, Francisca E; Serra, Estefanía; Simarro, Encarnación; Rojas, José; Ruiz, Joaquín

    2005-08-01

    Serum antibody detection tests and a urine antigen detection technique were compared in samples from 116 patients epidemiologically characterized as belonging to a legionellosis outbreak. Sera were tested by enzyme-linked immunosorbent assays (ELISAs) for immunoglobulin M (IgM) and IgG plus IgM and by immunofluorescent assays (IFAs) for IgG, IgM, IgA, and polyimmunoglobulin using commercial kits (Vircell); concentrated urines were tested with the Binax NOW Legionella test. ELISA for IgM, ELISA for IgG plus IgM, antigenuria detection, and IFA for IgM were able to diagnose 72.3%, 60.5%, 53.3%, and 51.4%, respectively, of patients. Antigenuria was present in 53.8% of first samples, ELISA detected IgM in 29.7%, ELISA detected IgG plus IgM in 7.9%, and IFA detected IgM in 3.9%. Ten antigenuria-negative first samples tested serologically positive, 9 of them to IgM by ELISA. Despite the single source of the samples included in the study, detection of IgM using a sensitive technique such as ELISA seems to be a suitable complement to antigenuria detection for the diagnosis of legionellosis.

  3. Value of Serological Testing for Diagnosis of Legionellosis in Outbreak Patients

    PubMed Central

    Rojas, Almudena; Navarro, M. Dolores; Fornés, Francisca E.; Serra, Estefanía; Simarro, Encarnación; Rojas, José; Ruiz, Joaquín

    2005-01-01

    Serum antibody detection tests and a urine antigen detection technique were compared in samples from 116 patients epidemiologically characterized as belonging to a legionellosis outbreak. Sera were tested by enzyme-linked immunosorbent assays (ELISAs) for immunoglobulin M (IgM) and IgG plus IgM and by immunofluorescent assays (IFAs) for IgG, IgM, IgA, and polyimmunoglobulin using commercial kits (Vircell); concentrated urines were tested with the Binax NOW Legionella test. ELISA for IgM, ELISA for IgG plus IgM, antigenuria detection, and IFA for IgM were able to diagnose 72.3%, 60.5%, 53.3%, and 51.4%, respectively, of patients. Antigenuria was present in 53.8% of first samples, ELISA detected IgM in 29.7%, ELISA detected IgG plus IgM in 7.9%, and IFA detected IgM in 3.9%. Ten antigenuria-negative first samples tested serologically positive, 9 of them to IgM by ELISA. Despite the single source of the samples included in the study, detection of IgM using a sensitive technique such as ELISA seems to be a suitable complement to antigenuria detection for the diagnosis of legionellosis. PMID:16081945

  4. Home-based HIV voluntary counselling and testing (VCT) for improving uptake of HIV testing.

    PubMed

    Bateganya, Moses; Abdulwadud, Omar A; Kiene, Susan M

    2010-07-07

    The low uptake of HIV voluntary counselling and testing (VCT) has hindered global attempts to prevent new HIV infections and has limited scale-up of HIV care and treatment. Globally, only 10% of HIV-infected individuals are aware of their HIV status. One approach to increase uptake is home-based HIV VCT, which may be effective in increasing the number of patients on treatment and preventing new infections. To establish the effect of home-based HIV VCT on uptake of HIV testing We searched MEDLINE (February 2007), EMBASE (February 2007), CENTRAL (February 2007), AIDSearch (February 2007), LILACS, CINAHL and Sociofile. We also contacted relevant researchers. The original review search strategy was updated in 2008. Randomised controlled trials comparing home-based HIV VCT with other testing models Two review authors independently selected studies, assessed methodological quality, and extracted data. We planned to conduct statistical analysis using the Review Manager software and calculate summary statistics (relative risks (RRs) with 95% confidence intervals (CI)) for primary outcomes. Only one study from developing countries met the inclusion criteria and was included in the review. The study, a cluster randomised trial (10 clusters, n=849) compared VCT uptake between an optional location (including home-based) and a local clinic location in a population-based HIV survey. The study showed a higher uptake of VCT among participants in the optional-location group. Uptake was significantly greater in the optional-location group in those who were pre-test counselled only (RR=4.6; 95% CI 3.58 to 5.91); pretest counselled and tested (RR=4.6; 95% CI 3.51 to 5.92); and post-test counselled and received the test result (RR=4.8; 95% CI 3.62 to 6.21). This study, however, had significant methodological problems limiting further analysis and interpretation. Although home-based HIV VCT has the potential to enhance VCT uptake in developing countries, insufficient data exist to

  5. Evaluation of Antigens for Development of a Serological Test for Human African Trypanosomiasis

    PubMed Central

    Biéler, Sylvain; Waltenberger, Harald; Barrett, Michael P.; McCulloch, Richard; Mottram, Jeremy C.; Carrington, Mark; Schwaeble, Wilhelm; McKerrow, James; Phillips, Margaret A.; Michels, Paul A.; Büscher, Philippe; Sanchez, Jean-Charles; Bishop, Richard; Robinson, Derrick R.; Bangs, James; Ferguson, Michael; Nerima, Barbara; Albertini, Audrey; Michel, Gerd; Radwandska, Magdalena; Ndung’u, Joseph Mathu

    2016-01-01

    Background Control and elimination of human African trypanosomiasis (HAT) can be accelerated through the use of diagnostic tests that are more accurate and easier to deploy. The goal of this work was to evaluate the immuno-reactivity of antigens and identify candidates to be considered for development of a simple serological test for the detection of Trypanosoma brucei gambiense or T. b. rhodesiense infections, ideally both. Methodology/Principal Findings The reactivity of 35 antigens was independently evaluated by slot blot and ELISA against sera from both T. b. gambiense and T. b. rhodesiense infected patients and controls. The antigens that were most reactive by both tests to T. b. gambiense sera were the membrane proteins VSG LiTat 1.3, VSG LiTat 1.5 and ISG64. Reactivity to T. b. rhodesiense sera was highest with VSG LiTat 1.3, VSG LiTat 1.5 and SRA, although much lower than with T. b. gambiense samples. The reactivity of all possible combinations of antigens was also calculated. When the slot blot results of 2 antigens were paired, a VSG LiTat 1.3- ISG75 combination performed best on T. b. gambiense sera, while a VSG LiTat 1.3-VSG LiTat 1.5 combination was the most reactive using ELISA. A combination of SRA and either VSG LiTat 1.3 or VSG LiTat 1.5 had the highest reactivity on T. b. rhodesiense sera according to slot blot, while in ELISA, pairing SRA with either GM6 or VSG LiTat 1.3 yielded the best results. Conclusions This study identified antigens that were highly reactive to T. b. gambiense sera, which could be considered for developing a serological test for gambiense HAT, either individually or in combination. Antigens with potential for inclusion in a test for T. b. rhodesiense HAT were also identified, but because their reactivity was comparatively lower, a search for additional antigens would be required before developing a test for this form of the disease. PMID:27936225

  6. Evaluation of Antigens for Development of a Serological Test for Human African Trypanosomiasis.

    PubMed

    Biéler, Sylvain; Waltenberger, Harald; Barrett, Michael P; McCulloch, Richard; Mottram, Jeremy C; Carrington, Mark; Schwaeble, Wilhelm; McKerrow, James; Phillips, Margaret A; Michels, Paul A; Büscher, Philippe; Sanchez, Jean-Charles; Bishop, Richard; Robinson, Derrick R; Bangs, James; Ferguson, Michael; Nerima, Barbara; Albertini, Audrey; Michel, Gerd; Radwandska, Magdalena; Ndung'u, Joseph Mathu

    2016-01-01

    Control and elimination of human African trypanosomiasis (HAT) can be accelerated through the use of diagnostic tests that are more accurate and easier to deploy. The goal of this work was to evaluate the immuno-reactivity of antigens and identify candidates to be considered for development of a simple serological test for the detection of Trypanosoma brucei gambiense or T. b. rhodesiense infections, ideally both. The reactivity of 35 antigens was independently evaluated by slot blot and ELISA against sera from both T. b. gambiense and T. b. rhodesiense infected patients and controls. The antigens that were most reactive by both tests to T. b. gambiense sera were the membrane proteins VSG LiTat 1.3, VSG LiTat 1.5 and ISG64. Reactivity to T. b. rhodesiense sera was highest with VSG LiTat 1.3, VSG LiTat 1.5 and SRA, although much lower than with T. b. gambiense samples. The reactivity of all possible combinations of antigens was also calculated. When the slot blot results of 2 antigens were paired, a VSG LiTat 1.3- ISG75 combination performed best on T. b. gambiense sera, while a VSG LiTat 1.3-VSG LiTat 1.5 combination was the most reactive using ELISA. A combination of SRA and either VSG LiTat 1.3 or VSG LiTat 1.5 had the highest reactivity on T. b. rhodesiense sera according to slot blot, while in ELISA, pairing SRA with either GM6 or VSG LiTat 1.3 yielded the best results. This study identified antigens that were highly reactive to T. b. gambiense sera, which could be considered for developing a serological test for gambiense HAT, either individually or in combination. Antigens with potential for inclusion in a test for T. b. rhodesiense HAT were also identified, but because their reactivity was comparatively lower, a search for additional antigens would be required before developing a test for this form of the disease.

  7. Indirect fluorescent-antibody and quantitative agar-gel immunodiffusion tests for the serological diagnosis of paracoccidioidomycosis.

    PubMed

    Restrepo, A; Moncada, L H

    1972-07-01

    The value of various serological tests in the diagnosis of paracoccidioidomycosis was studied. Quantitative agar-gel immunodiffusion and indirect immunofluorescent tests were performed, and the results were compared with those of complement fixation and qualitative agar-gel procedures. The quantitative immunodiffusion procedure was found to serve as the simplest and safest quantitative test that could be performed for evaluation purposes, whereas the indirect fluorescent-antibody test gave nonspecific reactions and, as such, proved unsuitable.

  8. Is Expanded HIV Testing Associated with Earlier HIV Diagnosis? Results from an HIV Clinic in Guatemala City.

    PubMed

    Liggett, Alisha; Medina, Narda; Samayoa, Blanca; Mercado, Danicela; Castillo, Mirna; Argueta, Erwin; Anderson, Miguel; Anderson, Matthew; Arathoon, Eduardo

    2016-05-01

    Most patients in Guatemala are diagnosed with advanced HIV disease. Patients that present late in the disease process may miss the morbidity and mortality benefits associated with early treatment and may unknowingly spread HIV to others. We examined trends in HIV detection and levels of immunosuppression at diagnosis from 2005 -2012 to determine if expanded HIV testing was associated with earlier detection of HIV. This study was conducted at the Clínica Familiar Luis Ángel García (CFLAG), a major HIV center associated with one of Guatemala's two national hospitals. HIV testing expanded rapidly after 2007 due to grants from the Global Fund which allowed for routine prenatal testing. This study examined existing hospital and clinic databases from to evaluate results from HIV tests performed, and baseline CD4 cells/mm(3) on all patients newly diagnosed with HIV infection from 2005 to 2012. We found a decline in the number of HIV positive tests over the study period despite an increase in the total number of tests performed. Sixty-two percent of HIV infected individuals had AIDS at diagnosis. We observed a decrease in median CD4 cells/mm(3) among the prenatal testees and no change in non-prenatal testees. Expanded HIV counseling and testing services in our clinic did not result in earlier HIV diagnosis. © The Author(s) 2016.

  9. Do commercial serologic tests for Trypanosoma cruzi infection detect Mexican strains in women and newborns?

    PubMed

    Gamboa-León, Rubi; Gonzalez-Ramirez, Claudia; Padilla-Raygoza, Nicolas; Sosa-Estani, Sergio; Caamal-Kantun, Alejandra; Buekens, Pierre; Dumonteil, Eric

    2011-04-01

    We sought to determine the serological test that could be used for Trypanosoma cruzi seroprevalence studies in Mexico, where lineage I predominates. In a previous study among pregnant women and their newborns in the states of Yucatan and Guanajuato, we reported a 0.8-0.9% of prevalence for T. cruzi -specific antibodies by Stat-Pak and Wiener ELISA. We have expanded this study here by performing an additional non-commercial ELISA and confirming the seropositives with Western blot, using whole antigens of a local parasite strain. We found a seroprevalence of 0.6% (3/500) in Merida and 0.4% in Guanajuato (2/488). The 5 seropositive umbilical cord samples reacted to both non-commercial ELISA and Western blot tests, and only 1 of the maternal samples was not reactive to non-commercial ELISA. A follow-up of the newborns at 10 mo was performed in Yucatan to determine the presence of T. cruzi antibodies in children as evidence of congenital infection. None of the children was seropositive. One newborn from an infected mother died at 2 wk of age of cardiac arrest, but T. cruzi infection was not confirmed. The T. cruzi seroprevalence data obtained with both commercial tests (Stat-Pak and ELISA Wiener) are similar to those from non-commercial tests using a local Mexican strain of T. cruzi.

  10. DO COMMERCIAL SEROLOGIC TESTS FOR TRYPANOSOMA CRUZI INFECTION DETECT MEXICAN STRAINS IN WOMEN AND NEWBORNS?

    PubMed Central

    Gamboa-León, Rubi; Gonzalez-Ramirez, Claudia; Padilla-Raygoza, Nicolas; Sosa-Estani, Sergio; Caamal-Kantun, Alejandra; Buekens, Pierre; Dumonteil, Eric

    2012-01-01

    We sought to determine the serological test that could be used for Trypanosoma cruzi seroprevalence studies in Mexico, where lineage I predominates. In a previous study among pregnant women and their newborns in the states of Yucatan and Guanajuato, we reported a 0.8–0.9% of prevalence for T. cruzi–specific antibodies by Stat-Pak and Wiener ELISA. We have expanded this study here by performing an additional non-commercial ELISA and confirming the seropositives with Western blot, using whole antigens of a local parasite strain. We found a seroprevalence of 0.6% (3/500) in Merida and 0.4% in Guanajuato (2/488). The 5 seropositive umbilical cord samples reacted to both non-commercial ELISA and Western blot tests, and only 1 of the maternal samples was not reactive to non-commercial ELISA. A follow-up of the newborns at 10 mo was performed in Yucatan to determine the presence of T. cruzi antibodies in children as evidence of congenital infection. None of the children was seropositive. One newborn from an infected mother died at 2 wk of age of cardiac arrest, but T. cruzi infection was not confirmed. The T. cruzi seroprevalence data obtained with both commercial tests (Stat-Pak and ELISA Wiener) are similar to those from non-commercial tests using a local Mexican strain of T. cruzi. PMID:21506787

  11. 75 FR 75809 - Guidance for Industry: Use of Serological Tests To Reduce the Risk of Transmission of Trypanosoma...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-06

    ... Health and Human Services Food and Drug Administration Guidance for Industry: Use of Serological Tests To...; ] DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration Guidance for Industry: Use of... Components Intended for Transfusion; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice...

  12. An outbreak of foodborne hepatitis A: the value of serologic testing and matched case-control analysis.

    PubMed Central

    Gustafson, T L; Hutcheson, R H; Fricker, R S; Schaffner, W

    1983-01-01

    In April 1981, an outbreak of hepatitis A occurred among state legislators in Tennessee. Although the number of cases was small, we traced the source to a food handler who served cold meats and cheese. This investigation demonstrates the value of rapid serologic testing using a radioimmunoassay technique and matched case-control analysis to identify small foodborne outbreaks of hepatitis A. PMID:6311035

  13. Comparison of Four Serological Tests for Detecting Antibodies to Japanese Encephalitis Virus after Vaccination in Children

    PubMed Central

    Cha, Go Woon; Cho, Jung Eun; Ju, Young Ran; Hong, Young-Jin; Han, Myung Guk; Lee, Won-Ja; Choi, Eui Yul; Jeong, Young Eui

    2014-01-01

    Objectives Several different methods are currently used to detect antibodies to Japanese encephalitis virus (JEV) in serum samples or cerebrospinal fluid. These methods include the plaque reduction neutralization test (PRNT), the hemagglutination inhibition (HI) test, indirect immunofluorescence assay (IFA), and enzyme-linked immunosorbent assay (ELISA). The purpose of this study was to compare the performance of each method in detecting vaccine-induced antibodies to JEV. Methods The study included 29 children who had completed a primary immunization schedule with an inactivated vaccine against JEV derived from mouse brain (n = 15) or a live attenuated SA14-14-2 vaccine (n = 14). Serum samples were collected between 3 months and 47 months after the last immunization. The serum samples were tested by performing the PRNT, HI test, in-house IFA, and commercial ELISA. The antibody detection rates were compared between tests. Results All 29 serum samples were positive with the PRNT, showing antibody titers from 1:20 to 1:2560. The HI test showed positive rates of 86.7% (13/15) and 71.4% (10/14) in the inactivated and live attenuated vaccine groups, respectively. The results of the IFA for immunoglobulin (Ig)G were positive in 53.3% (8/15) of children in the inactivated vaccine group and 35.7% (5/14) in the live attenuated vaccine group. Neither the IFA nor ELISA detected JEV IgM antibodies in any of the 29 children. Conclusion These results show that detection rates of vaccine-induced antibodies to JEV have a wide range (0–100%) depending on the testing method as well as the time since immunization and individual differences between children. These findings are helpful in interpreting serological test results for the diagnosis of Japanese encephalitis in situations where vaccines are widely administered. PMID:25389515

  14. Product-specific validation of a serological potency test for release of Leptospira vaccines in the European Union.

    PubMed

    Stirling, Catrina; Novokova, Viera

    2013-09-01

    Historically in the European Union, all Leptospira vaccines were released using the European Pharmacopoeia (Ph. Eur.) hamster potency assay. Recently, there has been a shift toward alternatives that offer either refinement of testing or replacement of animals for product release. This is being driven by animal welfare concerns but also by a drive to have more consistent, cheaper, and faster batch release tests. This publication discusses one such example of a multicomponent canine vaccine that includes three Leptospira serovars and has recently been registered in the European Union. The potency release test is a refinement because it uses rabbit serology rather than hamster challenge. This publication covers the principles of the test method, challenges faced during its development and registration, and discussion about benefits and limitations of this method. It concludes with a view of how the use of serology testing could fit into an overall strategy to move to fully in vitro testing by adopting a consistency approach.

  15. Frequent HIV Testing: Impact on HIV Risk Among Chinese Men Who Have Sex with Men

    PubMed Central

    Liu, Yu; Qian, Han-Zhu; Ruan, Yuhua; Wu, Pingsheng; Osborn, Chandra Y.; Jia, Yujiang; Yin, Lu; Lu, Hongyan; He, Xiong; Shao, Yiming; Vermund, Sten H.

    2016-01-01

    Background The HIV epidemic continues to expand among men who have sex with men (MSM) in China. The NIMH Project Accept/HPTN 043 trial suggested a borderline significant trend towards HIV incidence reduction among persons with higher testing rates. Methods We assessed HIV testing histories and infection status among a community-based Beijing MSM. HIV serostatus was lab-confirmed. We ascertained demographic/behavioral factors via questionnaire-based interviews. Associations of prior HIV testing with odds of current HIV infection were assessed, seeking improved like-with-like risk comparisons through multivariable logistic regression analysis with propensity score adjustment and restricted cubic spline modeling. Results Among 3,588 participants, 12.7% were HIV-infected; 70.8 % reported having ever tested for HIV. Compared to MSM who never tested, those ever testing had a 41% reduction in the odds of being HIV-positive (adjusted odds ratio [aOR], 0.59; 95% confidence interval [CI]: 0.48, 0.74). Higher HIV testing frequencies were associated with a decreasing trend in the odds of being infected with HIV vs. a referent group with no prior testing (>6 tests [aOR: 0.27; 95%CI: 0.18, 0.41]; 4–6 [aOR: 0.55; 95%CI: 0.39, 0.78]; 2–3 [aOR: 0.61; 95%CI: 0.45, 0.82]; P for trend <0.001). The multivariable adjusted model with restricted cubic spline of HIV testing frequency showed a higher frequency of prior HIV testing associated with lower odds of HIV infection, particularly among men with ≥10 lifetime male sexual partners. Conclusions Using risk probability adjustments to enable less biased comparisons, frequent HIV testing was associated with a lower HIV odds among Chinese MSM. PMID:27003496

  16. Serology with ML Flow test in health professionals from three different states of Brazil*

    PubMed Central

    Calado, Karla Lucena Sampaio; Magnanini, Mônica Maria Ferreira; de Moura, Rodrigo Scaliante; Gallo, Maria Eugenia Noviski; Bührer-Sékula, Samira; de Oliveira, Maria Leide Wand-Del-Rey

    2013-01-01

    BACKGROUND In highly endemic countries, transmission and sub-clinical infection of leprosy are likely and the disease manifests itself in individuals without any known close contact with a leprosy patient. Health workers are social contacts belonging to the same network (the Health System) and some of them share the same social environment (nursing assistants) as patients with known patients and / or carriers. OBJECTIVE To identify ML Flow seropositivity among health professionals. METHODS We conducted a cross-sectional study using a serological survey with the ML Flow test in 450 health professionals (doctors, nurses and nursing assistants), in order to detect seropositivity in areas of high and low endemicity in municipalities from three Brazilian states (RJ, MS and RS). RESULTS The results showed general 16% seropositivity, higher in low endemic areas, regardless of whether there was direct care for leprosy patients. Paradoxically, a statistical association was observed between the area studied and seropositivity, as the place with the lowest endemicity (CA) had the highest seropositivity rate (p = 0.033). CONCLUSION The authors suggest these results are associated with a presence of an unspecified link to bovine serum albumin (BSA), carrier of PGL-1 in the ML Flow test, and recommend expanded seroepidemiological research utilizing tests with human and bovine albumin. PMID:24474100

  17. Comparison of serological tests for the detection of ovine and caprine antibody to Brucella melitensis.

    PubMed

    Nielsen, K; Gall, D; Smith, P; Balsevicius, S; Garrido, F; Ferrer, M Durán; Biancifiori, F; Dajer, A; Luna, E; Samartino, L; Bermudez, R; Moreno, F; Renteria, T; Corral, A

    2004-12-01

    The indirect enzyme-linked immunosorbent assay (IELISA), the competitive enzyme-linked immunosorbent assay (CELISA) and the fluorescence polarisation assay (FPA) were evaluated with sera from sheep experimentally infected with Brucella melitensis and negative Canadian sheep. The sensitivity and specificity of the assays were as follows: IELISA: 91.7% and 97.6%, CELISA: 75.0% and 99.8% and FPA: 91.7% and 89.5%. Sera from the same experimental population were divided according to serological reaction in the rose bengal agglutination test (RBT) and the complement fixation test (CFT). Reactivity relative to the RBT positive and CFT positive sera were as follows: IELISA: 99.7%, CELISA: 93.2% and FPA: 99.1%. Since sera from goats with proven B. melitensis infection were not available, 699 sera from goats judged positive in the buffered antigen plate agglutination test (BPAT) and CFT and 982 BPAT/CFT negative Canadian goats were used. The sensitivity and specificity of the assays relative to the BPAT and CFT positive sera were: IELISA: 99.4% and 98.0%, CELISA: 95.4% and 97.1% and FPA: 92.7% and 99.8%.

  18. STEREOTYPES ABOUT PEOPLE LIVING WITH HIV: IMPLICATIONS FOR PERCEPTIONS OF HIV RISK AND TESTING FREQUENCY AMONG AT-RISK POPULATIONS

    PubMed Central

    Earnshaw, Valerie A.; Smith, Laramie R.; Chaudoir, Stephenie R.; Lee, I-Ching; Copenhaver, Michael M.

    2013-01-01

    Although research continues to demonstrate that HIV stigma is associated with decreased HIV testing, the psychological processes implicated in this association remain unclear. The authors address this gap by differentiating between the HIV stigma mechanisms of stereotypes, prejudice, and discrimination. They hypothesize that HIV stereotypes specifically, more so than prejudice or discrimination, are associated with HIV testing among at-risk populations. Ninety-three HIV-negative people receiving methadone maintenance therapy at a clinic in the northeastern United States participated by completing a survey. Results demonstrated that HIV stereotypes are associated with HIV testing via the mediator of perceived HIV risk. As hypothesized, prejudice, discrimination, and objective HIV risk were not associated with perceived HIV risk. Differentiating between HIV stigma mechanisms in future work can provide critical insight into how to intervene in HIV stigma to increase HIV testing and improve HIV prevention among at-risk populations. PMID:23206205

  19. Stereotypes about people living with HIV: implications for perceptions of HIV risk and testing frequency among at-risk populations.

    PubMed

    Earnshaw, Valerie A; Smith, Laramie R; Chaudoir, Stephenie R; Lee, I-Ching; Copenhaver, Michael M

    2012-12-01

    Although research continues to demonstrate that HIV stigma is associated with decreased HIV testing, the psychological processes implicated in this association remain unclear. The authors address this gap by differentiating between the HIV stigma mechanisms of stereotypes, prejudice, and discrimination. They hypothesize that HIV stereotypes specifically, more so than prejudice or discrimination, are associated with HIV testing among at-risk populations. Ninety-three HIV-negative people receiving methadone maintenance therapy at a clinic in the northeastern United States participated by completing a survey. Results demonstrated that HIV stereotypes are associated with HIV testing via the mediator of perceived HIV risk. As hypothesized, prejudice, discrimination, and objective HIV risk were not associated with perceived HIV risk. Differentiating between HIV stigma mechanisms in future work can provide critical insight into how to intervene in HIV stigma to increase HIV testing and improve HIV prevention among at-risk populations.

  20. Rapid Quantitative Serological Test for Detection of Infection with Mycobacterium leprae, the Causative Agent of Leprosy

    PubMed Central

    Balagon, Marivic F.; Maghanoy, Armi; Orcullo, Florenda M.; Cang, Marjorie; Dias, Ronaldo Ferreira; Collovati, Marco; Reed, Steven G.

    2014-01-01

    Leprosy remains an important health problem in a number of regions. Early detection of infection, followed by effective treatment, is critical to reduce disease progression. New sensitive and specific tools for early detection of infection will be a critical component of an effective leprosy elimination campaign. Diagnosis is made by recognizing clinical signs and symptoms, but few clinicians are able to confidently identify these. Simple tests to facilitate referral to leprosy experts are not widely available, and the correct diagnosis of leprosy is often delayed. In this report, we evaluate the performance of a new leprosy serological test (NDO-LID). As expected, the test readily detected clinically confirmed samples from patients with multibacillary (MB) leprosy, and the rate of positive results declined with bacterial burden. NDO-LID detected larger proportions of MB and paucibacillary (PB) leprosy than the alternative, the Standard Diagnostics leprosy test (87.0% versus 81.7% and 32.3% versus 6.5%, respectively), while also demonstrating improved specificity (97.4% versus 90.4%). Coupled with a new cell phone-based test reader platform (Smart Reader), the NDO-LID test provided consistent, objective test interpretation that could facilitate wider use in nonspecialized settings. In addition, results obtained from sera at the time of diagnosis, versus at the end of treatment, indicated that the quantifiable nature of this system can also be used to monitor treatment efficacy. Taken together, these data indicate that the NDO-LID/Smart Reader system can assist in the diagnosis and monitoring of MB leprosy and can detect a significant number of earlier-stage infections. PMID:24478496

  1. Rapid quantitative serological test for detection of infection with Mycobacterium leprae, the causative agent of leprosy.

    PubMed

    Duthie, Malcolm S; Balagon, Marivic F; Maghanoy, Armi; Orcullo, Florenda M; Cang, Marjorie; Dias, Ronaldo Ferreira; Collovati, Marco; Reed, Steven G

    2014-02-01

    Leprosy remains an important health problem in a number of regions. Early detection of infection, followed by effective treatment, is critical to reduce disease progression. New sensitive and specific tools for early detection of infection will be a critical component of an effective leprosy elimination campaign. Diagnosis is made by recognizing clinical signs and symptoms, but few clinicians are able to confidently identify these. Simple tests to facilitate referral to leprosy experts are not widely available, and the correct diagnosis of leprosy is often delayed. In this report, we evaluate the performance of a new leprosy serological test (NDO-LID). As expected, the test readily detected clinically confirmed samples from patients with multibacillary (MB) leprosy, and the rate of positive results declined with bacterial burden. NDO-LID detected larger proportions of MB and paucibacillary (PB) leprosy than the alternative, the Standard Diagnostics leprosy test (87.0% versus 81.7% and 32.3% versus 6.5%, respectively), while also demonstrating improved specificity (97.4% versus 90.4%). Coupled with a new cell phone-based test reader platform (Smart Reader), the NDO-LID test provided consistent, objective test interpretation that could facilitate wider use in nonspecialized settings. In addition, results obtained from sera at the time of diagnosis, versus at the end of treatment, indicated that the quantifiable nature of this system can also be used to monitor treatment efficacy. Taken together, these data indicate that the NDO-LID/Smart Reader system can assist in the diagnosis and monitoring of MB leprosy and can detect a significant number of earlier-stage infections.

  2. Validation of Serological Tests for the Detection of Antibodies Against Treponema pallidum in Nonhuman Primates

    PubMed Central

    Knauf, Sascha; Dahlmann, Franziska; Batamuzi, Emmanuel K.; Frischmann, Sieghard; Liu, Hsi

    2015-01-01

    There is evidence to suggest that the yaws bacterium (Treponema pallidum ssp. pertenue) may exist in non-human primate populations residing in regions where yaws is endemic in humans. Especially in light of the fact that the World Health Organizaiton (WHO) recently launched its second yaws eradication campaign, there is a considerable need for reliable tools to identify treponemal infection in our closest relatives, African monkeys and great apes. It was hypothesized that commercially available serological tests detect simian anti-T. pallidum antibody in serum samples of baboons, with comparable sensitivity and specificity to their results on human sera. Test performances of five different treponemal tests (TTs) and two non-treponemal tests (NTTs) were evaluated using serum samples of 57 naturally T. pallidum-infected olive baboons (Papio anubis) from Lake Manyara National Park in Tanzania. The T. pallidum particle agglutination assay (TP-PA) was used as a gold standard for comparison. In addition, the overall infection status of the animals was used to further validate test performances. For most accurate results, only samples that originated from baboons of known infection status, as verified in a previous study by clinical inspection, PCR and immunohistochemistry, were included. All tests, TTs and NTTs, used in this study were able to reliably detect antibodies against T. pallidum in serum samples of infected baboons. The sensitivity of TTs ranged from 97.7-100%, while specificity was between 88.0-100.0%. The two NTTs detected anti-lipoidal antibodies in serum samples of infected baboons with a sensitivity of 83.3% whereas specificity was 100%. For screening purposes, the TT Espline TP provided the highest sensitivity and specificity and at the same time provided the most suitable format for use in the field. The enzyme immune assay Mastblot TP (IgG), however, could be considered as a confirmatory test. PMID:25803295

  3. Validation of serological tests for the detection of antibodies against Treponema pallidum in nonhuman primates.

    PubMed

    Knauf, Sascha; Dahlmann, Franziska; Batamuzi, Emmanuel K; Frischmann, Sieghard; Liu, Hsi

    2015-03-01

    There is evidence to suggest that the yaws bacterium (Treponema pallidum ssp. pertenue) may exist in non-human primate populations residing in regions where yaws is endemic in humans. Especially in light of the fact that the World Health Organizaiton (WHO) recently launched its second yaws eradication campaign, there is a considerable need for reliable tools to identify treponemal infection in our closest relatives, African monkeys and great apes. It was hypothesized that commercially available serological tests detect simian anti-T. pallidum antibody in serum samples of baboons, with comparable sensitivity and specificity to their results on human sera. Test performances of five different treponemal tests (TTs) and two non-treponemal tests (NTTs) were evaluated using serum samples of 57 naturally T. pallidum-infected olive baboons (Papio anubis) from Lake Manyara National Park in Tanzania. The T. pallidum particle agglutination assay (TP-PA) was used as a gold standard for comparison. In addition, the overall infection status of the animals was used to further validate test performances. For most accurate results, only samples that originated from baboons of known infection status, as verified in a previous study by clinical inspection, PCR and immunohistochemistry, were included. All tests, TTs and NTTs, used in this study were able to reliably detect antibodies against T. pallidum in serum samples of infected baboons. The sensitivity of TTs ranged from 97.7-100%, while specificity was between 88.0-100.0%. The two NTTs detected anti-lipoidal antibodies in serum samples of infected baboons with a sensitivity of 83.3% whereas specificity was 100%. For screening purposes, the TT Espline TP provided the highest sensitivity and specificity and at the same time provided the most suitable format for use in the field. The enzyme immune assay Mastblot TP (IgG), however, could be considered as a confirmatory test.

  4. Providing HIV results via SMS one day after testing: more popular than rapid point-of-care tests.

    PubMed

    Davies, Stephen C; Koh, Andrew; Lindsay, Heather E; Fulton, Richard B; Fernando, Suran L

    2017-06-01

    An inner Sydney sexual health service introduced the option to gay and bisexual men of receiving a negative HIV result by SMS to mobile phone one business day after venipuncture (rapid SMS). Men could also choose one of the other options: a point-of-care-test (POCT), by phone, or in-person (clinicians could also require in-person). We followed-up patients choosing the rapid SMS method to ascertain their satisfaction. During 12 months, 473 men had 591 HIV tests. Of these tests, 5.4% were POCTs, 9.1% were in-person, 24% were by phone, and 62% were rapid SMS. HIV POCTs declined from being 22% of result methods in the pre-study period to 5.4% during the rapid SMS intervention period (odds ratio 0.20, 95% CI 0.13-0.32, P < 0.0001). Phone/in-person results declined from 78% to 33% (odds ratio 0.14, 95% CI 0.10-0.20, P < 0.0001). SMS was sent by the next business day in 95% of cases; 96% of men were satisfied; and 95% would choose this method for their next test. Of 77 men who previously had an HIV POCT, 56 (73%) elected a rapid SMS result rather than having another POCT. The higher accuracy of conventional serology was commonly expressed as the reason for choosing rapid SMS for results.

  5. Association between distance to HIV testing site and uptake of HIV testing for tuberculosis patients in Cambodia.

    PubMed

    Kanara, N; Cain, K P; Chhum, V; Eng, B; Kim, S; Keo, S; Heller, T A; Varma, J K

    2009-02-01

    Banteay Meanchey Province, Cambodia. Cambodia has the highest incidence of tuberculosis (TB) in Asia. Not all TB patients are tested for human immunodeficiency virus (HIV). We assessed the association between distance to HIV testing facility and HIV testing rates. We analyzed data on TB patients from 11 clinics to determine the proportion tested for HIV infection. We categorized each TB clinic as having a voluntary confidential counseling and testing (VCCT) center onsite, or being at <15 min, 15-30 min or >30 min driving distance to the nearest VCCT. Of 1017 TB patients not previously tested for HIV, 708 (70%) were tested. Of 481 TB patients without onsite VCCT, 297 (62%) were tested, compared to 410 (77%) of 535 TB patients with onsite VCCT (RR 0.6, 95%CI 0.5-0.7). When the VCCT site was >15 min from the TB clinic, HIV testing occurred only half as frequently as when onsite VCCT was available. TB patients treated at clinics without onsite or nearby HIV testing are less commonly tested for HIV infection. Making HIV testing available to TB patients without the necessity of traveling to a distant HIV testing site is likely to increase HIV testing rates.

  6. Clinical and serological tests for arboviruses in free-living domestic pigeons (Columba livia)

    PubMed Central

    Ramos, Bruna Alves; Chiang, Jannifer Oliveira; Martins, Lívia Carício; Chagas, Liliane Leal das; Silva, Franko de Arruda e; Ferreira, Milene Silveira; Freitas, Maria Nazaré Oliveira; de Alcantara, Bianca Nascimento; da Silva, Sandro Patroca; Miranda, Stefânia Araújo; Sepulvreda, Barbara Alves; Corrêa, Layna Thayssa Guimarães; Negrão, Andréa Maria Góes; Vasconcelos, Pedro Fernando da Costa; Casseb, Alexandre do Rosário

    2017-01-01

    BACKGROUND In this study, we evaluated the role of free-living domestic pigeons (Columba livia) as a reservoir of arboviruses in the city of Belém, state of Pará, Brazil. We investigated the presence of antibodies against the most prevalent arboviruses. OBJECTIVES This study was aimed at evaluating some clinical and physical parameters of domestic pigeons, including the presence of antibodies to Amazon-endemic arboviruses. METHODS Eighty-five healthy pigeons were captured in Mangal das Garças Park, in Belém, and were bled. Upon capture, the birds were subjected to a clinical examination in search of alterations that could indicate the presence of arboviruses. Blood samples were converted to serum and tested using the haemagglutination inhibition (HI) technique with a panel of 19 antigens of arboviruses circulating in the Amazon. The confirmation assay for the positive reactions to the viral species tested by HI was a neutralisation test in new-born Swiss albino mice (Mus musculus) [mouse neutralisation test (MNT)]. FINDINGS A total of 10 (11.8%) serum samples tested positive for antiflavivirus antibodies by HI. All the samples positive for the HI test were subjected to MNT for detection of viruses and yielded negative results (logarithmic neutralisation index < 1.7). MAIN CONCLUSION The results represent the first serological detection of antiarbovirus antibodies in domestic pigeons as potential hosts of arboviruses in Brazil. The detection of haemagglutination-inhibiting antibodies against genus Flavivirus indicated that there was recent contact between the analysed domestic pigeons and these arboviruses. Further studies are needed to evaluate the role of free-living pigeons in the maintenance cycle and spread of arboviruses in the Amazon. PMID:28767977

  7. HIV Testing Patterns among Urban YMSM of Color

    ERIC Educational Resources Information Center

    Leonard, Noelle R.; Rajan, Sonali; Gwadz, Marya V.; Aregbesola, Temi

    2014-01-01

    The heightened level of risk for HIV infection among Black and Latino young men who have sex with men (YMSM) is driven by multilevel influences. Using cross-sectional data, we examined HIV testing patterns among urban YMSM of color in a high-HIV seroprevalence area (ages 16 to 21 years). Self-reported frequency of testing was high, with 42% of…

  8. A Comprehensive Sex Education Approach for HIV Testing and Counselling

    ERIC Educational Resources Information Center

    Colpin, Hilde

    2006-01-01

    Despite huge prevention efforts the number of HIV infections worldwide continues to increase dramatically. Among other strategies, the HIV test offers an important chance for targeted prevention, provided quality counselling is offered. Several studies have revealed that HIV testing is often performed in less than optimal conditions and is often…

  9. A Comprehensive Sex Education Approach for HIV Testing and Counselling

    ERIC Educational Resources Information Center

    Colpin, Hilde

    2006-01-01

    Despite huge prevention efforts the number of HIV infections worldwide continues to increase dramatically. Among other strategies, the HIV test offers an important chance for targeted prevention, provided quality counselling is offered. Several studies have revealed that HIV testing is often performed in less than optimal conditions and is often…

  10. HIV Testing Patterns among Urban YMSM of Color

    ERIC Educational Resources Information Center

    Leonard, Noelle R.; Rajan, Sonali; Gwadz, Marya V.; Aregbesola, Temi

    2014-01-01

    The heightened level of risk for HIV infection among Black and Latino young men who have sex with men (YMSM) is driven by multilevel influences. Using cross-sectional data, we examined HIV testing patterns among urban YMSM of color in a high-HIV seroprevalence area (ages 16 to 21 years). Self-reported frequency of testing was high, with 42% of…

  11. Dengue antibodies in Polish travellers returning from the tropics. Evaluation of serological tests.

    PubMed

    Goljan, Jolanta; Myjak, Przemysław; Nahorski, Wacław; Kubica-Biernat, Beata; Felczak-Korzybska, Iwona; Kowalczyk, Danuta; Kuna, Anna; Kotłowski, Andrzej

    2010-01-01

    Dengue is a viral disease caused by an RNA virus of the genus Flavivirus, family Flaviviridae, occurring as four serotypes (DEN-1, -2, -3, -4). It is transmitted to humans by the Aedes mosquitoes, mainly A. aegypti. The occurrence of dengue is strictly related with their preferred breeding areas. Dengue endemic regions are inhabited by some 2.5 billion people. 50-100 million cases of dengue fever and up to 1 million cases of dengue haemorrhagic fever are noted worldwide in more than 100 countries every year. The aim of the reported examinations was to diagnose dengue virus infections in returning travellers. In the years 2006-2009 serological tests were performed in 753 persons. In the diagnostics we used ELISA to find IgM and/or IgG class of antibodies against dengue virus, rapid immunochromatographic (cassette) test, NS1 viral antigen detection by ELISA, and virus RNA detection by RT-PCR method. IgM or IgG class antibodies, and both classes simultaneously, were detected in 19.8% of the examined cases. The greatest number of infections came from India and the Far East, next from South and Central America, and the smallest number from Africa. Sixteen patients with diagnosed dengue, including three cases of dengue haemorrhagic fever, were hospitalized.

  12. The Dutch Brucella abortus monitoring programme for cattle: the impact of false-positive serological reactions and comparison of serological tests.

    PubMed

    Emmerzaal, A; de Wit, J J; Dijkstra, Th; Bakker, D; van Zijderveld, F G

    2002-02-01

    The Dutch national Brucella abortus eradication programme for cattle started in 1959. Sporadic cases occurred yearly until 1995; the last infected herd was culled in 1996. In August 1999 the Netherlands was declared officially free of bovine brucellosis by the European Union. Before 1999, the programme to monitor the official Brucella-free status of bovine herds was primarily based on periodical testing of dairy herds with the milk ring test (MRT) and serological testing of all animals older than 1 year of age from non-dairy herds, using the micro-agglutination test (MAT) as screening test. In addition, serum samples of cattle that aborted were tested with the MAT. The high number of false positive reactions in both tests and the serum agglutination test (SAT) and complement fixation test (CFT) used for confirmation seemed to result in unnecessary blockade of herds, subsequent testing and slaughter of animals. For this reason, a validation study was performed in which three indirect enzyme-linked immunosorbent assays (ELISAs), the CFT and the SAT were compared using a panel of sera from brucellosis-free cattle, sera from experimentally infected cattle, and sera from cattle experimentally infected with bacteria which are known to induce cross-reactive antibodies (Pasteurella, Salmonella, Yersinia, and Escherichia). Moreover, four ELISAs and the MRT were compared using a panel of 1000 bulk milk samples from Brucella-free herds and 12 milk samples from Brucella abortus- infected cattle. It is concluded that the ELISA obtained from ID-Lelystad is the most suitable test to monitor the brucelosis free status of herds because it gives rise to fewer false-positive reactions than the SAT.

  13. Application of Mycobacterium Leprae-specific cellular and serological tests for the differential diagnosis of leprosy from confounding dermatoses.

    PubMed

    Freitas, Aline Araújo; Hungria, Emerith Mayra; Costa, Maurício Barcelos; Sousa, Ana Lúcia Osório Maroccolo; Castilho, Mirian Lane Oliveira; Gonçalves, Heitor Sá; Pontes, Maria Araci Andrade; Duthie, Malcolm S; Stefani, Mariane Martins Araújo

    2016-10-01

    Mycobacterium leprae-specific serological and cell-mediated-immunity/CMI test were evaluated for the differential diagnosis of multibacillary/MB, and paucibacillary/PB leprosy from other dermatoses. Whole-blood assay/WBA/IFNγ stimulated with LID-1 antigen and ELISA tests for IgG to LID-1 and IgM to PGL-I were performed. WBA/LID-1/IFNγ production was observed in 72% PB, 11% MB leprosy, 38% dermatoses, 40% healthy endemic controls/EC. The receiver operating curve/ROC for WBA/LID-1 in PB versus other dermatoses showed 72.5% sensitivity, 61.5% specificity and an area-under-the-curve/AUC=0.75; 74% positive predictive value/PPV, 59% negative predictive value/NPV. Anti PGL-I serology was positive in 67% MB, 8% PB leprosy, 6% of other dermatoses; its sensitivity for MB=66%, specificity=93%, AUC=0.89; PPV=91%, NPV=72%. Anti-LID-1 serology was positive in 87% MB, 7% PB leprosy, all other participants were seronegative; 87.5% sensitivity for MB, 100% specificity, AUC=0.97; PPV=100%, NPV=88%. In highly endemic areas anti-LID-1/PGL-I serology and WBA/LID-1-represent useful tools for the differential diagnosis of leprosy from other confounding dermatoses. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Gender, Sexual Orientation, and Adolescent HIV Testing: A Qualitative Analysis

    PubMed Central

    Siegel, Karolynn; Lekas, Helen-Maria; Olson, Kari; VanDevanter, Nancy

    2010-01-01

    Using qualitative data, this article explored the circumstances leading to HIV testing among 59 HIV-infected adolescents recruited from New York City HIV clinics. Results showed differences between the heterosexual women and the gay and bisexual men. Most of the young women were tested during routine health care or self-initiated tests, and most were asymptomatic when they tested positive. Their testing decisions were sometimes based on assessments of their boyfriends’ risk behaviors, rather than their own. Many males were experiencing symptoms of illness when they tested positive, and about half of these recognized their symptoms as related to HIV and sought tests. Some young men expressed fear of learning about positive test results, which delayed their testing, and some providers did not initially recommend HIV testing for males who presented with symptoms. The article concludes that consideration of these gender and sexual orientation-related concerns can facilitate HIV testing among adolescents. PMID:20303793

  15. Comparison of the serological tests ICT and ELISA for the diagnosis of alveolar echinococcosis in France.

    PubMed

    Knapp, Jenny; Sako, Yasuhito; Grenouillet, Frédéric; Bresson-Hadni, Solange; Richou, Carine; Gbaguidi-Haore, Houssein; Ito, Akira; Millon, Laurence

    2014-01-01

    Serological diagnosis of alveolar echinococcosis (AE) is a key element for efficient patient treatment management. A rapid immunochromatography test kit (ICT) using the recombinant Em18 antigen (rEm18) was recently developed. The aim of our study was to assess this test on a panel of sera from French patients with alveolar echinococcosis and control patients. In a blind test, a total of 112 serum samples were tested including samples of AE (n = 30), cystic echinococcosis [CE] (n = 15), and polycystic echinococcosis [PE] (n = 1). For the comparison, 66 sera from patients with hepatocarcinoma, fascioliasis, toxocariasis, Caroli's disease, or autoimmune chronic active hepatitis were used. The diagnostic test sets we used were the rEm18-ICT and two validated ELISAs with rEm18 and Em2-Em18 antigens, respectively. For the ICT, 27/30 sera from AE patients, 4/15 sera from CE patients and the PE patient serum were positive. One serum from the control panel (toxocariasis) was positive for the ICT. The rEm18-ICT sensitivity (90.0%) and specificity (92.7%) for detection of Em18-specific antibodies confirmed it as a relevant tool for AE diagnosis. The rEm18-ELISA had a sensitivity of 86.7% and specificity of 91.5%, and the Em2-Em18-ELISA had a sensitivity of 96.7% and specificity of 87.8%. However, when AE patient sera are recorded as weak in intensity with the ICT, we recommend a double reading and use of a reference sample if the ICT is used for patient follow-up.

  16. HIV risk behavior and access to services: what predicts HIV testing among heterosexually active homeless men?

    PubMed

    Wenzel, Suzanne L; Rhoades, Harmony; Tucker, Joan S; Golinelli, Daniela; Kennedy, David P; Zhou, Annie; Ewing, Brett

    2012-06-01

    HIV is a serious epidemic among homeless persons, where rates of infection are estimated to be three times higher than in the general population. HIV testing is an effective tool for reducing HIV transmission and for combating poor HIV/AIDS health outcomes that disproportionately affect homeless persons, however, little is known about the HIV testing behavior of homeless men. This study examined the association between individual (HIV risk) and structural (service access) factors and past year HIV testing. Participants were a representative sample of 305 heterosexually active homeless men interviewed from meal programs in the Skid Row region of Los Angeles. Logistic regression examined the association between past year HIV testing and demographic characteristics, HIV risk behavior, and access to other services in the Skid Row area in the past 30 days. Despite high rates of past year HIV testing, study participants also reported high rates of HIV risk behavior, suggesting there is still significant unmet need for HIV prevention among homeless men. Having recently used medical/dental services in the Skid Row area (OR: 1.91; CI: 1.09, 3.35), and being a military veteran (OR: 2.10; CI: 1.01-4.37) were significantly associated with HIV testing service utilization. HIV testing was not associated with HIV risk behavior, but rather with access to services and veteran status, the latter of which prior research has linked to increased service access. We suggest that programs encouraging general medical service access may be important for disseminating HIV testing services to this high-risk, vulnerable population.

  17. HIV testing and linkage to services for youth

    PubMed Central

    Kurth, Ann E; Lally, Michelle A; Choko, Augustine T; Inwani, Irene W; Fortenberry, J Dennis

    2015-01-01

    Introduction HIV testing is the portal to serostatus knowledge that can empower linkage to care for HIV treatment and HIV prevention. However, young people's access to HIV testing is uneven worldwide. The objective of this paper is to review the context and concerns faced by youth around HIV testing in low- as well as high-income country settings. Discussion HIV testing is a critical entry point for primary and secondary prevention as well as care and treatment for young people including key populations of vulnerable youth. We provide a framework for thinking about the role of testing in the continuum of prevention and care for young people. Brief case study examples from Kenya and the US illustrate some of the common barriers and issues involved for young people. Conclusions Young people worldwide need more routine access to HIV testing services that effectively address the developmental, socio-political and other issues faced by young women and men. PMID:25724506

  18. Missed opportunities for HIV control: Gaps in HIV testing for partners of people living with HIV in Lima, Peru

    PubMed Central

    Errea, Renato A.; Hoces, Daniel; Echevarria, Juan; González-Lagos, Elsa; Gotuzzo, Eduardo

    2017-01-01

    Introduction Based on the hypothesis that HIV programs struggle to deliver health services that harmonize necessities of treatment and prevention, we described the outcomes of routinely provided HIV testing to partners of people living with HIV (PLWH) through a secondary analysis of routine data collected at a public hospital in Lima, Peru. Methods Among PLWH enrolled in the study center’s HIV program between 2005 and 2014, we identified index cases (IC): PLWH who reported a unique partner not previously enrolled. We grouped partners according to their HIV status as reported by IC and collected data on HIV testing, clinical characteristics and admissions. The main outcome was the frequency of HIV testing among partners with reported unknown/seronegative HIV status. Results Out of 1586 PLWH who reported a unique partner at enrollment, 171 had a previously enrolled partner, leaving 1415 (89%) IC. HIV status of the partner was reported as unknown in 571 (40%), seronegative in 325 (23%) and seropositive in 519 (37%). Out of 896 partners in the unknown/seronegative group, 72 (8%) had HIV testing, 42/72 (58%) tested within three months of IC enrollment. Among the 49/72 (68%) who tested positive for HIV, 33 (67%) were enrolled in the HIV program. The proportion in WHO clinical stage IV was lower in enrolled partners compared to IC (37% vs 9%, p = 0.04). Non-tested partners (824) were likely reachable by the hospital, as 297/824 (36%) of their IC were admitted in the study center at least once, 51/243 (21%) female IC had received pregnancy care at the study center, and 401/692 (64%) of IC on antiretroviral therapy had achieved viral suppression, implying frequent visits to the hospital for pill pick-up. Conclusion In this setting, HIV testing of partners of PLWH was suboptimal, illustrating missed opportunities for HIV control. Integration of HIV strategies in primarily clinical-oriented services is a challenging need. PMID:28806412

  19. Clinical utility of serologic testing for celiac disease in asymptomatic patients: an evidence-based analysis.

    PubMed

    2011-01-01

    The objective of this evidence-based analysis was to evaluate the clinical utility of serologic testing for celiac disease in asymptomatic individuals presenting with one of the non-gastrointestinal conditions evaluated in this report. The clinical utility was based on the effects of a gluten-free diet (GFD) on outcomes specific to each of these conditions. The prevalence of celiac disease in asymptomatic individuals and one of these non-gastrointestinal conditions was also evaluated. CELIAC DISEASE: Celiac disease is an autoimmune disease characterized by a chronic inflammatory state of the proximal small bowel mucosa accompanied by structural and functional changes. TECHNOLOGY UNDER EVALUATION: SEROLOGIC TESTS FOR CELIAC DISEASE: There are a number of serologic tests for celiac disease available. Serologic tests are automated with the exception of the anti-endomysial antibody test, which is more time-consuming and operator-dependent than the other tests. What is the prevalence of asymptomatic celiac disease in patients presenting with one of the non-gastrointestinal conditions evaluated?What is the effect of the gluten-free diet on condition-specific outcomes in patients with asymptomatic celiac disease presenting with one of the non-gastrointestinal conditions evaluated?What is the clinical utility of serologic testing for celiac disease in asymptomatic patients presenting with one of the non-gastrointestinal conditions evaluated? The clinical utility was defined as the impact of the GFD on disease specific outcomes.What is the risk of all-cause mortality and lymphoma in individuals with asymptomatic celiac disease?What is the budget impact of serologic testing for celiac disease in asymptomatic subjects presenting with one of the non-gastrointestinal conditions evaluated? The study population consisted of individuals with newly diagnosed celiac disease without any symptoms consistent with the disease presenting with one of the non-gastrointestinal conditions

  20. HIV testing and clinical status upon admission to a specialized health care unit in Pará, Brazil

    PubMed Central

    Abati, Paulo Afonso Martins; Segurado, Aluisio Cotrim

    2015-01-01

    OBJECTIVE To analyze the clinical and laboratory characteristics of HIV-infected individuals upon admission to a reference health care center. METHODS This cross-sectional study was conducted between 1999 and 2010 on 527 individuals with confirmed serological diagnosis of HIV infection who were enrolled in an outpatient health care service in Santarém, PA, Northern Brazil. Data were collected from medical records and included the reason for HIV testing, clinical status, and count of peripheral CD4+ T lymphocytes upon enrollment. The data were divided into three groups, according to the patient’s year of admission – P1 (1999-2002), P2 (2003-2006), and P3 (2007-2010) – for comparative analysis of the variables of interest. RESULTS In the study group, 62.0% of the patients were assigned to the P3 group. The reason for undergoing HIV testing differed between genders. In the male population, most tests were conducted because of the presence of symptoms suggesting infection. Among women, tests were the result of knowledge of the partner’s seropositive status in groups P1 and P2. Higher proportion of women undergoing testing because of symptoms of HIV/AIDS infection abolished the difference between genders in the most recent period. A higher percentage of patients enrolling at a more advanced stage of the disease was observed in P3. CONCLUSIONS Despite the increased awareness of the number of HIV/AIDS cases, these patients have identified their serological status late and were admitted to health care units with active disease. The HIV/AIDS epidemic in Pará presents specificities in its progression that indicate the complex characteristics of the epidemic in the Northern region of Brazil and across the country. PMID:25741647

  1. Comparison of serological and molecular test for diagnosis of infectious mononucleosis

    PubMed Central

    Salehi, Hassan; Salehi, Marziyeh; Roghanian, Rasoul; Bozari, Majid; Taleifard, Shirin; Salehi, Mohamad Mahdi; Salehi, Maryam

    2016-01-01

    Background: Epstein-Bar virus (EBV) is the main etiology of infectious mononucleosis (IM) syndrome that is characterized by fever, sore throat, and lymph adenopathy. Since, this virus could be associated with a number of malignancies, some hematologic disorders, and chronic fatigue syndrome, identification of IM is very important. The aim of study was to evaluate the specificity, as well as sensitivity of the two different methods that is, serology versus molecular diagnosis that are currently used for diagnosis of IM. Materials and Methods: In this study, during a period of 3.5 years, 100 suspected patients as case group and 100 healthy individuals as a control group were studied. Fifty samples in each group were tested by polymerase chain reaction (PCR) and all the samples including case group and control group were carried out by enzyme-linked immunosorbent assay (ELISA). Results: In 76% of patients and in 20% of the healthy individuals, samples were detected EBV DNA by PCR. On the other hand, 68.5% of the samples belong to the case group and 46% in the control group showed positivity by ELISA. Conclusion: By comparing the two methods, since PCR is very expensive and time consuming, and the percentages of difference ranges are narrow, ELISA could be applied as a first, easiest, and preliminary diagnostic test for IM. In addition, this test could be applied in various phases of the disease with a higher sensitivity comparing to PCR. Although PCR is routinely used for diagnosis of various infectious agents, it is considered as an expensive test and merely could be used after 1-2 weeks from the onset of the illness. PMID:27308267

  2. Further standardization of the agglutinin-absorption test in the serology of leptospires*

    PubMed Central

    Kmety, Emil; Galton, Mildred M.; Sulzer, Catherine R.

    1970-01-01

    Four factors, suspected of influencing the final results of agglutinin-absorption tests used in the diagnosis and classification of leptospires, were investigated in comparative studies: (1) the time required for adequate absorption, (2) the quantitative relationship between antibody titres and amounts of antigen needed for absorption, (3) the possible effect of the Danysz phenomenon, and (4) the absorptive potency of live and formol-treated antigen. It was found that a 90-minute absorption time was adequate and that with increasing amounts of antigen, titres were continuously reduced, indicating a certain degree of non-specific absorption. The Danysz phenomenon was found to occur in leptospiral serology and the addition of antigen to serum in 3 equal parts at 10-minute intervals is recommended. The titres of sera absorbed with formol-treated antigen were often found to be lower than titres of sera absorbed with the same amounts of live antigen and some damaging effect of formol on antibody is suspected. PMID:5311059

  3. Uptake of Workplace HIV Counselling and Testing: A Cluster-Randomised Trial in Zimbabwe

    PubMed Central

    Corbett, Elizabeth L; Dauya, Ethel; Matambo, Ronnie; Cheung, Yin Bun; Makamure, Beauty; Bassett, Mary T; Chandiwana, Steven; Munyati, Shungu; Mason, Peter R; Butterworth, Anthony E; Godfrey-Faussett, Peter; Hayes, Richard J

    2006-01-01

    Background HIV counselling and testing is a key component of both HIV care and HIV prevention, but uptake is currently low. We investigated the impact of rapid HIV testing at the workplace on uptake of voluntary counselling and testing (VCT). Methods and Findings The study was a cluster-randomised trial of two VCT strategies, with business occupational health clinics as the unit of randomisation. VCT was directly offered to all employees, followed by 2 y of open access to VCT and basic HIV care. Businesses were randomised to either on-site rapid HIV testing at their occupational clinic (11 businesses) or to vouchers for off-site VCT at a chain of free-standing centres also using rapid tests (11 businesses). Baseline anonymised HIV serology was requested from all employees. HIV prevalence was 19.8% and 18.4%, respectively, at businesses randomised to on-site and off-site VCT. In total, 1,957 of 3,950 employees at clinics randomised to on-site testing had VCT (mean uptake by site 51.1%) compared to 586 of 3,532 employees taking vouchers at clinics randomised to off-site testing (mean uptake by site 19.2%). The risk ratio for on-site VCT compared to voucher uptake was 2.8 (95% confidence interval 1.8 to 3.8) after adjustment for potential confounders. Only 125 employees (mean uptake by site 4.3%) reported using their voucher, so that the true adjusted risk ratio for on-site compared to off-site VCT may have been as high as 12.5 (95% confidence interval 8.2 to 16.8). Conclusions High-impact VCT strategies are urgently needed to maximise HIV prevention and access to care in Africa. VCT at the workplace offers the potential for high uptake when offered on-site and linked to basic HIV care. Convenience and accessibility appear to have critical roles in the acceptability of community-based VCT. PMID:16796402

  4. Assessing Targeted Screening and Low Rates of HIV Testing

    PubMed Central

    Kennedy, Leigh A.; Gordin, Fred M.

    2010-01-01

    Objectives. We assessed rates of HIV testing based on targeting patients with identified risk factors at the Veterans Affairs Medical Center in Washington, DC (VAMC-DC), where written informed consent along with pretest and posttest counseling had, until recently, been required by federal law. Methods. A cumulative retrospective review of the period 2000 through 2007 was conducted to assess the number of patients who were provided medical care at VAMC-DC, tested for HIV, and underwent confirmatory testing. Data on demographic characteristics and risks for HIV acquisition were also collected. Results. At VAMC-DC, 3.8% to 4.9% (mean = 4.25%) of patients in care without known HIV infection underwent HIV screening annually. On average, HIV was confirmed at a yearly rate of 3.4% among those tested. During the study period, HIV prevalence ranged from 2.1% to 2.5%. Among patients receiving HIV care, 41.5% disclosed no risk factors for HIV acquisition. Conclusions. Given that the HIV prevalence observed in this study was above 2% and that 41.5% of patients in care did not disclose any acquisition risks, targeted HIV screening has not been sufficient. HIV testing must be broadened and offered as part of routine medical care. PMID:20634454

  5. Specific antigen serologic tests in leprosy: implications for epidemiological surveillance of leprosy cases and household contacts

    PubMed Central

    Carvalho, Ana Paula Mendes; Coelho, Angélica da Conceição Oliveira; Correa-Oliveira, Rodrigo; Lana, Francisco Carlos Félix

    2017-01-01

    BACKGROUND There is a lack of straightforward tests for field application and known biomarkers for predicting leprosy progression in infected individuals. OBJECTIVE The aim was to analyse the response to infection by Mycobacterium leprae based on the reactivity of specific antigens: natural disaccharide linked to human serum albumin via an octyl (NDOHSA), a semisynthetic phenolic glycolipid-I (PGL-I); Leprosy Infectious Disease Research Institute Diagnostic-1 (LID-1) and natural disaccharide octyl - Leprosy Infectious Disease Research Institute Diagnostic-1 (NDOLID). METHODS The study population consisted of 130 leprosy cases diagnosed between 2010 and 2015 and 277 household contacts. An enzyme-linked immunosorbent assay (ELISA) was used to analyse the reactivity of antibodies against NDOHSA, LID-1 and NDOLID. The samples and controls were tested in duplicate, and the antibody titer was expressed as an ELISA index. Data collection was made by home visits with application of questionnaire and dermatological evaluation of all household contacts to identify signs and symptoms of leprosy. FINDINGS Significant differences in the median ELISA results were observed among leprosy cases in treatment, leprosy cases that had completed treatment and household contacts. Higher proportions of seropositivity were observed in leprosy cases in treatment. Seropositivity was also higher in multibacillary in relation to paucibacillary, with the difference reaching statistical significance. Lower titers were observed among cases with a longer treatment time or discharge. For household contacts, the differences according to the clinical characteristics of the leprosy index case were less pronounced than expected. Other factors, such as the endemicity of leprosy, exposure outside the residence and genetic characteristics, appeared to have a greater influence on the seropositivity. MAIN CONCLUSIONS Serologic tests could be used as auxiliary tools for determining the operational

  6. Determinants and prevalence of late HIV testing in Tijuana, Mexico.

    PubMed

    Carrizosa, Claudia M; Blumberg, Elaine J; Hovell, Melbourne F; Martinez-Donate, Ana P; Garcia-Gonzalez, Gregorio; Lozada, Remedios; Kelley, Norma J; Hofstetter, C Richard; Sipan, Carol L

    2010-05-01

    Timely diagnosis of HIV is essential to improve survival rates and reduce transmission of the virus. Insufficient progress has been made in effecting earlier HIV diagnoses. The Mexican border city of Tijuana has one of the highest AIDS incidence and mortality rates in all of Mexico. This study examined the prevalence and potential correlates of late HIV testing in Tijuana, Mexico. Late testers were defined as participants who had at least one of: (1) an AIDS-defining illness within 1 year of first positive HIV test; (2) a date of AIDS diagnosis within 1 year of first positive HIV test; or (3) an initial CD4 cell count below 200 cells per microliter within 1 year of first positive HIV test. Medical charts of 670 HIV-positive patients from two HIV/AIDS public clinics in Tijuana were reviewed and abstracted; 362 of these patients were interviewed using a cross-sectional survey. Using multivariate logistic regression, we explored potential correlates of late HIV testing based on the Behavioral Ecological Model. From 342 participants for whom late testing could be determined, the prevalence of late testing was 43.2%. Multivariate logistic regression results (n = 275) revealed five significant correlates of late testing: "I preferred not to know I had HIV" (adjusted odds ratio [AOR] = 2.78, 1.46-5.31); clinic (AOR = 1.90, 1.06-3.41); exposure to peers engaging in high-risk sexual behavior (AOR = 1.14, 1.02-1.27); stigma regarding HIV-infected individuals (AOR = 0.65, 0.47-0.92); and stigma regarding HIV testing (AOR = 0.66, 0.45-0.97). These findings may inform the design of interventions to increase timely HIV testing and help reduce HIV transmission in the community at large.

  7. Sensitivity of the STAT-VIEW rapid self-test and implications for use during acute HIV infection.

    PubMed

    Boukli, Narjis; Boyd, Anders; Wendremaire, Noémie; Girard, Pierre-Marie; Bottero, Julie; Morand-Joubert, Laurence

    2017-08-23

    HIV testing is an important step towards diminishing incident infections. Rapid self-tests whose use is becoming more common in France could help increase access to testing, yet could fail to diagnose HIV during acute HIV infection (AHI). The aim of the present study was to evaluate HIV-detection sensitivity of a commonly used rapid self-test (STAT-VIEW HIV1/2), compared with another point-of-care rapid test (INSTI), among patients presenting with AHI. Individuals tested at Saint-Antoine Hospital (Paris, France) with negative or indeterminate western blot (WB) results and detectable HIV-RNA were included. Rapid tests were performed retrospectively on stored serum. Patients with and without reactive rapid tests were compared, while probability of having a reactive test was modelled across infection duration using logistic regression. Of the 40 patients with AHI, 23 (57.5%) had a reactive STAT-VIEW rapid test. Patients with non-reactive versus reactive tests had a significantly shorter median time since infection (p=0.01), time since onset of symptoms (p=0.009), higher proportion with Fiebig stage III versus IV (p=0.003), negative WB results (p=0.007), higher HIV-RNA levels (p=0.001) and lower CD4+ and CD8+ cell count (p=0.03, p<0.001, respectively). When examining sensitivity over the course of AHI duration, the probability of HIV detection was 75.5% at 5 weeks from HIV transmission. The INSTI provided similar results with respect to proportion of reactive tests (62.5%), determinants for non-reactive test and probability of HIV detection at 5 weeks of infection (85.0%). Over half of AHI patients had reactive serology using the STAT-VIEW rapid self-test when performed on serum samples. Considering that detection sensitivity increased substantially over infection time, individuals should not rely on a negative result to accurately exclude HIV infection within at least 5 weeks of potential HIV exposure. Notwithstanding strong recommendations against rapid test

  8. A Review of Serological Tests to Assist Diagnosis of Reactive Arthritis: Critical Appraisal on Methodologies

    PubMed Central

    Tuuminen, Tamara; Lounamo, Kari; Leirisalo-Repo, Marjatta

    2013-01-01

    On a population-based level, the incidence of reactive arthritis (ReA) is 0.6–27/100,000. The definition of ReA varies and its pathogenesis is not yet clear. Attempts in basic immunology to suggest hypotheses for proliferation of forbidden B cell clones, molecular mimicry, and involvement of cross-reactive antibodies are helpful but not sufficient. Importantly, for the clinical diagnosis of the preceding infection, serology is widely used. Unfortunately, the accuracy of associations between serologic findings and clinical conclusions is plagued by poor standardization of methods. So far, few attempts have been done to examine the pitfalls of different approaches. Here, we review several serologic techniques, their performance and limitations. We will focus on serology for Yersinia, Campylobacter, Salmonella, Shigella, and Chlamydia trachomatis because these bacteria have a longer history of being associated with ReA. We also address controversies regarding the role of serology for some other bacteria linked to autoimmune disorders. PMID:24363655

  9. Toxoplasma gondii in Romanian household cats: evaluation of serological tests, epidemiology and risk factors.

    PubMed

    Györke, Adriana; Opsteegh, Marieke; Mircean, Viorica; Iovu, Anamaria; Cozma, Vasile

    2011-12-15

    Felines are the key species in the epidemiology of Toxoplasma gondii infection, as they are the definitive host of the parasite and are the only species that can shed resistant oocysts in the environment. Different assays are in use for the detection of antibodies against T. gondii in cats. However, assay validation studies are limited. For that reason it was our aim to first evaluate 6 serological tests (one commercial and 2 in-house ELISAs, ImmunoComb, IFAT and MAT) for antibodies (IgG) against T. gondii in cats by Bayesian modeling. Factors associated with seropositivity were evaluated by bivariable and multivariable methods. The test evaluation indicated the commercial ELISA had the highest Youden Index. The estimated sensitivity ranged between 95.7% and 97.1% and the specificity between 97.3% and 97.6%. Using this commercial ELISA 111 out of 236 cats (47%) were positive for T. gondii antibodies. Two peaks in the percentage of strong positive samples (S/P≥200) were observed, around 10-months-old and 8-years-old. In bivariable analysis the seroprevalence was significantly higher in adult cats, cats with mixed diet, with outdoor access, in cats from a rural area and in cats from centre and north-western Romania. Adult age (adults: OR 6.98; 95% CI: 2.02-24.14 and geriatrics (cats older than 10-years): OR 12.01; 95% CI: 1.60-90.15) and outdoor access (OR 6.38; 95% CI: 2.32-17.53) remained significant risk factors in the multivariable logistic regression analysis. Our results suggest that T. gondii infection is common in household cats in Romania, and especially in those with outdoor access. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. The UK national external quality assessment scheme in blood group serology. Compatibility testing 1981-1982: performance and practice.

    PubMed

    Holburn, A M; Prior, D

    1984-01-01

    The design of exercises of compatibility testing was modified in 1981 in order better to accommodate participants' serological practices. Ten reference laboratories were also enrolled in order to determine the 'correct' results for each exercise. In 1981-1982 3.5 to 36% of participants missed incompatibilities in exercises in which undiluted antibodies were issued and this did not represent an improvement over performance obtained in 1979-1980. Surveys were undertaken of antiglobulin test procedures and revealed that serological practices continue to change, old techniques are being modified, new techniques are being employed but standardization shows little overall improvement. Surveys of quality control procedures and of cross-match procedures for agglutination in albumin and for agglutination of enzyme treated cells show equal lack of standardization.

  11. Serology for tularemia

    MedlinePlus

    Tularemia test; Serology for Francisella tularensis ... This blood test is done when tularemia is suspected. ... Saunders; 2011:chap 44. Penn RL. Francisella tularensis (Tularemia). In: Bennett JE, Dolin R, Blaser MJ, eds. ...

  12. Comparison of a stool antigen test and serology for the diagnosis of Helicobacter pylori infection in mass survey.

    PubMed

    Shimoyama, Tadashi; Oyama, Takao; Matsuzaka, Masashi; Danjo, Kazuma; Nakaji, Shigeyuki; Fukuda, Shinsaku

    2009-04-01

    Serum antibody to Helicobacter pylori is tested in mass screening for gastric cancer along with the level of serum pepsinogens (PG) I and II. Recently, stool antigen tests have been developed as a new non-invasive test. We examined H. pylori infection by both serology and stool antigen test in a mass survey and compared the results to estimate applicability of stool antigen test for mass survey. A total of 994 healthy adults who received mass survey in April 2005 were tested. There were 379 men and 615 women, and the mean age was 57.7 years old. Stool samples were used to measure a H. pylori-specific antigen by enzyme immunoassay. Serum samples were tested for the prevalence of IgG antibody to H. pylori, and the level of PGs I and II was also measured to determine the presence of atrophic gastritis. Infection of H. pylori was defined as positive 61.4% and 56.4% by serology and stool antigen test, respectively. The concordance of both tests was not affected by gender and age of the subjects but difference was seen in subjects with atrophic gastritis. In particular, positivity of stool antigen test (81.8%) was significantly lower than that of serology (88.7%, p < .05) in 303 subjects with severe atrophic gastritis. Stool antigen test, which detects present but not previous infection of H. pylori, would be applicable to diagnose H. pylori infection in mass survey. Usefulness of stool antigen tests for the screening of gastric cancer should be examined.

  13. Beyond the end of exceptionalism: integrating HIV testing into routine medical care and HIV prevention.

    PubMed

    Smith, Rachel; Zetola, Nicola M; Klausner, Jeffrey D

    2007-08-01

    In September 2006, the US CDC issued new guidelines for HIV testing. These guidelines were designed not only to simplify and expand HIV testing but also to integrate testing into routine medical care in the USA. The nationwide implementation of these guidelines is currently facing several political and legal barriers. In this article, we examine the origins of current patient-driven and risk-based HIV testing in the USA and highlight shortcomings of this strategy. We then demonstrate how the changing HIV epidemic in the USA requires routine HIV screening at all points of contact in the medical system in order to control the HIV epidemic and how novel testing strategies could increase the yield of testing in these settings.

  14. Decisional balance, perceived risk and HIV testing practices.

    PubMed

    Lauby, Jennifer L; Bond, Lisa; Eroğlu, Dogan; Batson, Heather

    2006-01-01

    Improving our understanding of how individuals decide to take an HIV test is essential for designing effective programs to increase testing. This paper assesses the relationship of decisional balance and perceived risk to HIV testing history in a cross-sectional community sample of 1523 HIV-negative men and women at risk due to drug use or sexual behavior. We developed scales to measure perceived advantages (pros) and perceived disadvantages (cons) of taking an HIV test and assessed their content using factor analysis. Perceived risk was highly related to the pros and cons scales. Multivariate analyses revealed that the pros scale had positive associations with having ever tested and the number of tests taken, while the cons scale had negative associations with these testing measures. Perceived risk was not related to testing practices. These results suggest that interventions to increase HIV testing need to address anticipated positive and negative outcomes of getting tested.

  15. A Recombinant Positive Control for Serology Diagnostic Tests Supporting Elimination of Onchocerca volvulus

    PubMed Central

    Golden, Allison; Stevens, Eric J.; Yokobe, Lindsay; Faulx, Dunia; Kalnoky, Michael; Peck, Roger; Valdez, Melissa; Steel, Cathy; Karabou, Potochoziou; Banla, Méba; Soboslay, Peter T.; Adade, Kangi; Tekle, Afework H.; Cama, Vitaliano A.; Fischer, Peter U.; Nutman, Thomas B.; Unnasch, Thomas R.; de los Santos, Tala; Domingo, Gonzalo J.

    2016-01-01

    Background Serological assays for human IgG4 to the Onchocerca volvulus antigen Ov16 have been used to confirm elimination of onchocerciasis in much of the Americas and parts of Africa. A standardized source of positive control antibody (human anti-Ov16 IgG4) will ensure the quality of surveillance data using these tests. Methodology/Principal Findings A recombinant human IgG4 antibody to Ov16 was identified by screening against a synthetic human Fab phage display library and converted into human IgG4. This antibody was developed into different positive control formulations for enzyme-linked immunosorbent assay (ELISA) and rapid diagnostic test (RDT) platforms. Variation in ELISA results and utility as a positive control of the antibody were assessed from multiple laboratories. Temperature and humidity conditions were collected across seven surveillance activities from 2011–2014 to inform stability requirements for RDTs and positive controls. The feasibility of the dried positive control for RDT was evaluated during onchocerciasis surveillance activity in Togo, in 2014. When the anti-Ov16 IgG4 antibody was used as a standard dilution in horseradish peroxidase (HRP) and alkaline phosphatase (AP) ELISAs, the detection limits were approximately 1ng/mL by HRP ELISA and 10ng/mL by AP ELISA. Positive control dilutions and spiked dried blood spots (DBS) produced similar ELISA results. Used as a simple plate normalization control, the positive control antibody may improve ELISA data comparison in the context of inter-laboratory variation. The aggregate temperature and humidity monitor data informed temperature parameters under which the dried positive control was tested and are applicable inputs for testing of diagnostics tools intended for sub-Saharan Africa. As a packaged positive control for Ov16 RDTs, stability of the antibody was demonstrated for over six months at relevant temperatures in the laboratory and for over 15 weeks under field conditions. Conclusions The

  16. HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa

    PubMed Central

    Kalichman, S; Simbayi, L

    2003-01-01

    Objectives: A cornerstone of HIV prevention in South Africa is voluntary HIV antibody counselling and testing (VCT), but only one in five South Africans aware of VCT have been tested. This study examined the relation between HIV testing history, attitudes towards testing, and AIDS stigmas. Methods: Men (n = 224) and women (n = 276) living in a black township in Cape Town completed venue intercept surveys; 98% were black, 74% age 35 or younger. Results: 47% of participants had been tested for HIV. Risks for exposure to HIV were high and comparable among people tested and not tested. Comparisons on attitudes toward VCT, controlling for demographics and survey venue, showed that individuals who had not been tested for HIV and those tested but who did not know their results held significantly more negative testing attitudes than individuals who were tested, particularly people who knew their test results. Compared to people who had been tested, individuals who were not tested for HIV demonstrated significantly greater AIDS related stigmas; ascribing greater shame, guilt, and social disapproval to people living with HIV. Knowing test results among those tested was not related to stigmatising beliefs. Conclusions: Efforts to promote VCT in South Africa require education about the benefits of testing and, perhaps more important, reductions in stigmatising attitudes towards people living with AIDS. Structural and social marketing interventions that aim to reduce AIDS stigmas will probably decrease resistance to seeking VCT. PMID:14663117

  17. Performance of HIV Rapid Tests Among Breastfeeding, Malawian Infants.

    PubMed

    Smith, Emily R; Sheahan, Anna D; Heyderman, Robert S; Miller, William C; Wheeler, Stephanie; Hudgens, Michael; Nelson, Julie A E; Dube, Queen; Van Rie, Annelies

    2017-04-01

    Timely, accurate and affordable testing algorithms at point-of-care are critical for early infant HIV diagnosis and initiation of antiretroviral therapy in the postpartum period. We aimed to assess the utility of HIV rapid tests for young, breast-fed HIV-exposed infants in resource limited, high HIV burden settings. We collected data on the performance of 2 commonly used rapid tests (Determine and Unigold) in Malawi between 2008 and 2012 or at the University of North Carolina between 2014 and 2015. For each 3-month interval between ages 3 and 18 months, we calculated the sensitivity, specificity, positive and negative predictive values of each test compared with the HIV DNA/RNA PCR gold standard. We also assessed the utility of each rapid test to diagnose incident HIV infection during the breastfeeding period. Among 121 HIV-exposed infants who were negative at age 6 weeks, 21 (17.2%) became infected by 18 months. At 3 months of age, both rapid tests had minimal clinical value with specificity values of 7.0% [95% confidence interval (CI): 2.3-15.7] for Determine and 19.4% (95% CI: 11.1-30.5) for Unigold. Starting at age 6 and 9 months, the Unigold test could be used as a screening tool in the follow-up of HIV-exposed infants with specificity values of 83.7% (95% CI: 74.4-89.9) and 97.7% (95% CI: 94.6-99.7), respectively. Starting at age 12 months, the type of test became less important as both tests performed well in identifying HIV-free children, although both tests failed to detect some incident HIV infections. Updated guidelines for the use of rapid tests in young HIV-exposed children that explicitly take type of test and infant age into account are urgently needed to ensure optimal care for the 1.5 million HIV-exposed infants born annually.

  18. HIV testing, risk perception, and behaviour in the British population.

    PubMed

    Clifton, Soazig; Nardone, Anthony; Field, Nigel; Mercer, Catherine H; Tanton, Clare; Macdowall, Wendy; Johnson, Anne M; Sonnenberg, Pam

    2016-03-27

    To examine the relationship between HIV risk behaviour, risk perception and testing in Britain. A probability sample survey of the British population. We analyzed data on sexual behaviour, self-perceived HIV risk and HIV testing (excluding testing because of blood donation) from 13 751 sexually experienced men and women aged 16-74, interviewed between 2010 and 2012 using computer-assisted face-to-face and self-interviewing. Altogether, 3.5% of men and 5.4% of women reported having an HIV test in the past year. Higher perceived risk of HIV was associated with sexual risk behaviours and with HIV testing. However, the majority of those rating themselves as 'greatly' or 'quite a lot' at risk of HIV (3.4% of men, 2.5% of women) had not tested in the past year. This was also found among the groups most affected by HIV: MSM and black Africans. Within these groups, the majority reporting sexual risk behaviours did not perceive themselves as at risk and had not tested for HIV. Overall, 29.6% of men and 39.9% of women who tested for HIV in the past year could be classified as low risk across a range of measures. Most people who perceive themselves as at risk of HIV have not recently tested, including among MSM and black Africans. Many people tested in Britain are at low risk, reflecting current policy that aims to normalize testing. Strategies to further improve uptake of testing are needed, particularly in those at greatest risk, to further reduce undiagnosed HIV infection at late diagnoses.

  19. HIV testing, risk perception, and behaviour in the British population

    PubMed Central

    Clifton, Soazig; Nardone, Anthony; Field, Nigel; Mercer, Catherine H.; Tanton, Clare; Macdowall, Wendy; Johnson, Anne M.; Sonnenberg, Pam

    2016-01-01

    Objective: To examine the relationship between HIV risk behaviour, risk perception and testing in Britain. Design: A probability sample survey of the British population. Methods: We analyzed data on sexual behaviour, self-perceived HIV risk and HIV testing (excluding testing because of blood donation) from 13 751 sexually experienced men and women aged 16–74, interviewed between 2010 and 2012 using computer-assisted face-to-face and self-interviewing. Results: Altogether, 3.5% of men and 5.4% of women reported having an HIV test in the past year. Higher perceived risk of HIV was associated with sexual risk behaviours and with HIV testing. However, the majority of those rating themselves as ‘greatly’ or ‘quite a lot’ at risk of HIV (3.4% of men, 2.5% of women) had not tested in the past year. This was also found among the groups most affected by HIV: MSM and black Africans. Within these groups, the majority reporting sexual risk behaviours did not perceive themselves as at risk and had not tested for HIV. Overall, 29.6% of men and 39.9% of women who tested for HIV in the past year could be classified as low risk across a range of measures. Conclusion: Most people who perceive themselves as at risk of HIV have not recently tested, including among MSM and black Africans. Many people tested in Britain are at low risk, reflecting current policy that aims to normalize testing. Strategies to further improve uptake of testing are needed, particularly in those at greatest risk, to further reduce undiagnosed HIV infection at late diagnoses. PMID:26963528

  20. Factors associated with HIV testing among immigrants in Portugal.

    PubMed

    Dias, Sónia; Gama, Ana; Severo, Milton; Barros, Henrique

    2011-10-01

    This paper describes the uptake of HIV testing and its associated factors among a sample of immigrants in Portugal. A questionnaire was completed by 1,513 immigrants at the National Immigrant Support Centre, in Lisbon. The magnitude of the association between ever been HIV tested and socio-demographic variables was estimated by means of crude and adjusted odds ratios, and their 95% confidence intervals, using logistic regression. Approximately half of the participants reported having ever been HIV tested. Age, sex, educational level, region of origin, immigration status and knowing someone infected were independently associated with the HIV test uptake. Almost 90% of participants reported knowing where to obtain support on HIV-related issues. Most declared preferring doctors to get HIV information. However, only 9.2% had sought HIV information at the National Health Service. Our results suggest differences between migrant groups regarding HIV testing. Adopting more innovative approaches to HIV testing could improve the efficacy of HIV prevention strategies, especially among vulnerable groups within immigrant population as male and undocumented.

  1. The ethics of feedback of HIV test results in population-based surveys of HIV infection.

    PubMed

    Maher, Dermot

    2013-12-01

    Population-based disease prevalence surveys raise ethical questions, including whether participants should be routinely told their test results. Ethical guidelines call for informing survey participants of any clinically relevant finding to enable appropriate management. However, in anonymous surveys of human immunodeficiency virus (HIV) infection, participants can "opt out" of being given their test results or are offered the chance to undergo voluntary HIV testing in local counselling and testing services. This is aimed at minimizing survey participation bias. Those who opt out of being given their HIV test results and who do not seek their results miss the opportunity to receive life-saving antiretroviral therapy. The justification for HIV surveys without routine feedback of results to participants is based on a public health utility argument: that the benefits of more rigorous survey methods - reduced participation bias - outweigh the benefits to individuals of knowing their HIV status. However, people with HIV infection have a strong immediate interest in knowing their HIV status. In consideration of the ethical value of showing respect for people and thereby alleviating suffering, an argument based on public health utility is not an appropriate justification. In anonymous HIV surveys as well as other prevalence surveys of treatable conditions in any setting, participation should be on the basis of routine individual feedback of results as an integral part of fully informed participation. Ensuring that surveys are ethically sound may stimulate participation, increase a broader uptake of HIV testing and reduce stigmatization of people who are HIV-positive.

  2. Cultural influences on HIV testing among Latino youth.

    PubMed

    Ma, Mindy; Malcolm, Lydia R

    2016-01-01

    Young Latinos aged 13-24 years in the USA are disproportionately impacted upon by HIV. Despite the elevated risk, lower rates of HIV testing have been documented among Latino youth relative to other racial/ethnic groups. The objective of the current study was to examine the influence of acculturation and cultural values on HIV testing among Latino youth. The study consisted of 51 sexually experienced young Latinos aged 13-16 years from a major city in the Southeastern USA. Participants completed a survey on HIV testing history, cultural orientation and Latino cultural values. Results indicate that 21.6% of the young people had been tested for HIV. The number of times tested ranged from one to four (M = 1.9 ± 1.0). HIV testing was associated with US American cultural orientation and familism (and emphasis on strong family commitment, family support and emotional closeness). Participants with greater orientation to US American culture were more likely, whereas those who endorsed higher familism value were less likely, to have had an HIV test. For participants scoring high on familism, the desire to maintain family honour may serve as a deterrent to testing. Incorporating culturally relevant strategies, such as promoting sexual communication and conversations on HIV prevention within the family, may enhance testing and narrow the gap in HIV infection between Latino youth and other ethnic groups.

  3. The association between HIV media campaigns and number of patients coming forward for HIV antibody testing.

    PubMed Central

    Ross, J D; Scott, G R

    1993-01-01

    AIM--To assess the relationship between national and local media campaigns with respect to the number of patients requesting HIV antibody tests as a surrogate marker of the effectiveness of different campaign strategies. METHODS--Analysis by month of the numbers of HIV tests performed in the regional genitourinary (GUM) clinic for Lothian over a 5 year period and in the whole of Lothian Region, Scotland over a 3 year period. Changes in testing rates were monitored with respect to media campaigns over the same time period. RESULTS--Television based media campaigns produced the greatest increase in testing rates (average 46% increase over 2 months) compared with newspapers and poster campaigns (average 6% increase over 2 months). Regional HIV testing rates correlated significantly with GUM clinic testing rates. No increase in positive HIV tests was seen following media campaigns. CONCLUSIONS--Using HIV testing rates as a surrogate marker, television based media campaigns appear to be the most effective way of increasing awareness of HIV. The effect of media campaigns is short-lived indicating a need for constant reminder of the dangers of HIV infection. The increase in HIV testing occurs largely in the "worried well" with few additional HIV positive patients being identified. PMID:8335311

  4. Alternative HIV testing methods among populations at high risk for HIV infection.

    PubMed Central

    Greensides, Dawn R.; Berkelman, Ruth; Lansky, Amy; Sullivan, Patrick S.

    2003-01-01

    OBJECTIVE: The purpose of this study was to determine the levels of awareness and use of alternative HIV tests (home collection kit, oral mucosal transudate collection kit, and rapid tests) among people at high risk for HIV infection. METHODS: Data were collected as part of an anonymous, cross-sectional interview study--the HIV Testing Survey (HITS)--conducted in seven states from September 2000 to February 2001. Three high-risk populations were recruited: men who have sex with men, injection drug users, and high-risk heterosexuals. Respondents were asked about their awareness and use of alternative HIV tests. RESULTS: The overall awareness and use of the alternative tests was limited: 54% of respondents were aware of the home collection kit, 42% were aware of the oral mucosal transudate collection kit test, and 13% were aware of rapid tests. Among those aware of alternative tests, self-reported use of the tests was also low. The most common reasons given for not using alternative HIV tests were: preference for the standard test; concern that the results could be less accurate; and that alternative tests were not offered. CONCLUSIONS: The low levels of awareness and use of alternative HIV tests suggest that the potential for promoting testing among individuals at high risk for HIV by encouraging use of alternative HIV tests has not been fully realized. Alternative tests should be made more broadly available and should be accompanied by education about these tests for physicians and people at risk. Educational efforts should be evaluated to determine if promoting alternative HIV tests increases the numbers of people at risk for HIV who are tested. PMID:14563910

  5. Screening for sexually transmitted diseases in an HIV testing clinic; uptake and prevalence.

    PubMed Central

    Madge, S; Elford, J; Lipman, M C; Mintz, J; Johnson, M A

    1996-01-01

    OBJECTIVE: To estimate the prevalence of sexually transmitted diseases (STDs) and the acceptability of STD screening among people seeking an HIV antibody test in an established free standing HIV testing clinic. DESIGN: A 9 month period prevalence study conducted between August 1993 and April 1994. SETTING: The Same Day Testing Clinic (SDTC) for HIV antibodies at the Royal Free Hampstead NHS Trust Hospital, London. SUBJECTS: 242 males and 160 females attending the Same Day Testing Clinic. OUTCOME MEASURES: The prevalence of STDs including gonorrhoea, chlamydia, syphilis and hepatitis B and the percentage of clinic attenders accepting an STD screen. RESULTS: Of those invited to take part in the study 69% of the males (242/350) and 59% (160/269) of the females agreed to be screened although for a variety of reasons not everyone agreed to a full screen. Two cases of untreated syphilis, no cases of gonorrhoea and six cases of chlamydia were detected. Four people had active, previously undiagnosed herpes while three had genital warts. Evidence of previously unknown hepatitis B infection was found in 26 people. Despite a high level of previous contact with genitourinary medicine services, uptake of hepatitis B vaccination among those homosexual men eligible for immunisation was low (28%; 23/83). Nine (4%) of the males, but none of the females screened for STD were found to be HIV antibody positive. CONCLUSION: Among people seeking an HIV antibody test in an established free standing HIV testing clinic, the prevalence of acute STDs was low. However, evidence of previously undiagnosed hepatitis B infection was found in a number of subjects and uptake of vaccination among those most at risk had been low. While opportunistic screening for STD was acceptable to almost two thirds of HIV testing clinic attenders, a substantial minority nonetheless declined this offer. Selective STD screening could be offered to those people seeking an HIV test who report never having been

  6. Serological assays as alternatives to the Ph Eur challenge test for batch release of tetanus vaccines for human use.

    PubMed

    Winsnes, R; Hendriksen, C; Sesardic, D; Akkermans, A; Daas, A

    1999-01-01

    According to the European Pharmacopoeia (Ph Eur) monograph on Tetanus Vaccine (adsorbed) (1997: 0452), assessment of potency is based on a challenge test in guinea pigs or mice. The end-point is taken as paralysis or death. The test requires a large number of animals and causes severe distress. The aim of the present study was to refine the test, and reduce the number of animals needed, for batch release purposes. Serological assays having the potential of being internationally accepted, have been compared with Ph Eur assays. The study included five tetanus vaccines of various combinations and produced by different manufacturers. The results indicated an excellent correlation between enzyme-linked immunosorbent assay (ELISA) and the challenge test (about 93% predictive value), as well as between the toxin binding inhibition (ToBI) test and the challenge test (about 95% predictive value) and between ELISA and the ToBI test (r = 0.92). Antitoxin concentrations determined by ELISA and ToBI were generally in the same range. An overall good correlation was also seen for serum pools of the guinea pigs injected with equal vaccine doses, between toxin neutralisation test in mice (TNT) and ELISA (r = 0.93) as well as between TNT and ToBI (r = 0.97). The ultimate goal of this project was to determine whether serological assays can be used for testing combined vaccines, particularly for tetanus and diphtheria components, using sera from the same animals.

  7. HIV testing practices among New England college health centers

    PubMed Central

    2013-01-01

    Background The prevalence of human immunodeficiency virus (HIV) continues to increase among certain populations including young men who have sex with men (MSM). College campuses represent a potential setting to engage young adults and institute prevention interventions including HIV testing. The purpose of this study was to evaluate testing practices for HIV and other sexually transmitted infections (STIs) on college campuses. Methods Medical directors at four-year residential baccalaureate college health centers in New England were surveyed from June, 2011 to September, 2011. Thirty-one interviews were completed regarding experiences with HIV testing, acute HIV infection, other STI testing, and outreach efforts targeting specific at-risk groups such as MSM. Results Among schools that responded to the survey, less than five percent of students were tested for HIV at their local college health center in the past academic year (2010–2011). Significant barriers to HIV testing included cost and availability of rapid antibody testing. One-third of college health medical directors reported that their practitioners may not feel comfortable recognizing acute HIV infection. Conclusions Improved HIV testing practices are needed on college campuses. Programs should focus on outreach efforts targeting MSM and other at-risk populations. PMID:23496891

  8. Review of HIV Testing Efforts in Historically Black Churches

    PubMed Central

    Pichon, Latrice Crystal; Powell, Terrinieka Williams

    2015-01-01

    This paper aims to critically assess the state of HIV testing in African American churches. A comprehensive review of peer-reviewed publications on HIV testing in church-based settings was conducted by two independent coders. Twenty-six papers published between 1991 and 2015, representing 24 unique projects, were identified addressing at least one dimension of HIV testing. Thirteen faith-based projects have implemented HIV testing events or had clergy promote the importance of testing and knowing one’s HIV status, but empirical data and rigorous study designs were limited. Only eight papers reported onsite HIV testing in churches. Less than 5% of the studies reported the percentage of congregants who returned for their test results. Finally, no study has examined at baseline or post-intervention behavioral intentions to be screened for HIV. Future research is needed to evaluate the effectiveness of HIV testing in churches and to explore the possibilities of the role of the church and leadership structure in the promotion of HIV treatment and care. PMID:26030470

  9. Seroprevalence of HCV and HIV Infections by Year of Birth in Spain: Impact of US CDC and USPSTF Recommendations for HCV and HIV Testing

    PubMed Central

    Meijide, Héctor; Cañizares, Angelina; Castro-Iglesias, Ángeles; Delgado, Manuel; Pértega, Sonia; Pedreira, José; Bou, Germán; Poveda, Eva

    2014-01-01

    Background The US Centers for Disease Control and Prevention (CDC) recently add the advice of one-time testing of HCV infection in persons born during 1945–1965. Moreover, the US Preventive Services Task Force (USPSTF) newly recommended one-time HIV testing for persons aged 15–65. Herein, we evaluate the potential impact of these recommendations in a reference medical area of Spain. Methods All assays results entries for HCV and HIV serological markers ordered at a reference lab from primary care and specialized physicians between 2008 and 2012 were recorded in a medical area which covers 501,526 citizens in Northern Spain. The year of birth were also documented. Results A total of 108,159 anti-HCV-Ab results were generated during the study period. The global rate of anti-HCV-Ab+ was 7.7% (95% CI: 7.6%–7.9%), being more prevalent in men than women (8.6% vs. 4.5%). By year of birth, the highest prevalence was found in persons born between 1955 and 1970. HCV genotype 1 was the most prevalent (59.7%) followed by genotype 3 (22.7%). Regard HIV infection, among 65,279 anti-HIV results generated the prevalence of anti-HIV+ was 1.1% (95% CI: 1.0%–1.2%), being more frequent in men (2% vs 0.5%). The years of birth with highest rates of HIV infection exactly match with those for HCV infection. Conclusions The highest rates of HCV and HIV infections are found between 1960 and 1965. Different historical and social circumstances such as the huge intravenous drug use epidemic in the eighties in Spain, might explain it. Therefore, each country needs to determine its own HCV and HIV seroprevalences by year of birth to establish the proper recommendations for the screening of both infections. PMID:25436642

  10. Predictors of HIV testing among Latinos in Baltimore City.

    PubMed

    Chen, Nadine; Erbelding, Emily; Yeh, Hsin-Chieh; Page, Kathleen

    2010-12-01

    To better understand access to HIV testing and prevention services experienced by Latinos, we evaluated data compiled through Baltimore City Health Department HIV outreach efforts in 2008. Of 6,443 clients served, Latinos were more likely male, young, and less-educated than non-Latinos. A greater proportion of Latinos had never been tested for HIV compared to non-Latinos (63% vs. 20%, P < 0.001). Male gender (AOR 1.58, 95% CI 1.04, 2.44), >8th grade education (AOR 2.4, 95% CI 1.60, 3.60) were associated with accessing HIV testing in the past. Increasing age, identifying as gay or bisexual, history of sexually-transmitted disease, and injection drug use were also associated with reporting prior HIV testing. HIV prevention services for Latinos should expand to reach those who are younger, heterosexual, of lower educational level, and female.

  11. Ethnicity and HIV risk behaviour, testing and knowledge in Guatemala.

    PubMed

    Taylor, Tory M; Hembling, John; Bertrand, Jane T

    2015-01-01

    To describe levels of risky sexual behaviour, HIV testing and HIV knowledge among men and women in Guatemala by ethnic group and to identify adjusted associations between ethnicity and these outcomes. Data on 16,205 women aged 15-49 and 6822 men aged 15-59 from the 2008-2009 Encuesta Nacional de Salud Materno Infantil were used to describe ethnic group differences in sexual behaviour, HIV knowledge and testing. We then controlled for age, education, wealth and other socio-demographic factors in a multivariate logistic regression model to examine the effects of ethnicity on outcomes related to age at sexual debut, number of lifetime sex partners, comprehensive HIV knowledge, HIV testing and lifetime sex worker patronage (men only). The data show low levels of risky sexual behaviour and low levels of HIV knowledge among indigenous women and men, compared to other respondents. Controlling for demographic factors, indigenous women were more likely than other women never to have been tested for HIV and to lack comprehensive HIV knowledge. They were less likely to report early sexual debut and three or more lifetime sexual partners. Indigenous men were more likely than other men to lack comprehensive HIV knowledge and demonstrated lower odds of early sexual debut, 10 or more lifetime sexual partners and sex worker patronage. The Mayan indigenous population in Guatemala, while broadly socially vulnerable, does not appear to be at elevated risk for HIV based on this analysis of selected risk factors. Nonetheless, low rates of HIV knowledge and testing may be cause for concern. Programmes working in indigenous communities should focus on HIV education and reducing barriers to testing. Further research into the factors that underlie ethnic self-identity and perceived ethnicity could help clarify the relative significance of these measures for HIV risk and other health outcomes.

  12. Ethnicity and HIV risk behaviour, testing and knowledge in Guatemala

    PubMed Central

    Taylor, Tory M.; Hembling, John; Bertrand, Jane T.

    2015-01-01

    Objectives. To describe levels of risky sexual behaviour, HIV testing and HIV knowledge among men and women in Guatemala by ethnic group and to identify adjusted associations between ethnicity and these outcomes. Design. Data on 16,205 women aged 15–49 and 6822 men aged 15–59 from the 2008–2009 Encuesta Nacional de Salud Materno Infantil were used to describe ethnic group differences in sexual behaviour, HIV knowledge and testing. We then controlled for age, education, wealth and other socio-demographic factors in a multivariate logistic regression model to examine the effects of ethnicity on outcomes related to age at sexual debut, number of lifetime sex partners, comprehensive HIV knowledge, HIV testing and lifetime sex worker patronage (men only). Results. The data show low levels of risky sexual behaviour and low levels of HIV knowledge among indigenous women and men, compared to other respondents. Controlling for demographic factors, indigenous women were more likely than other women never to have been tested for HIV and to lack comprehensive HIV knowledge. They were less likely to report early sexual debut and three or more lifetime sexual partners. Indigenous men were more likely than other men to lack comprehensive HIV knowledge and demonstrated lower odds of early sexual debut, 10 or more lifetime sexual partners and sex worker patronage. Conclusions. The Mayan indigenous population in Guatemala, while broadly socially vulnerable, does not appear to be at elevated risk for HIV based on this analysis of selected risk factors. Nonetheless, low rates of HIV knowledge and testing may be cause for concern. Programmes working in indigenous communities should focus on HIV education and reducing barriers to testing. Further research into the factors that underlie ethnic self-identity and perceived ethnicity could help clarify the relative significance of these measures for HIV risk and other health outcomes. PMID:24834462

  13. Commercial Serological Tests for the Diagnosis of Active Pulmonary and Extrapulmonary Tuberculosis: An Updated Systematic Review and Meta-Analysis

    PubMed Central

    Steingart, Karen R.; Flores, Laura L.; Dendukuri, Nandini; Schiller, Ian; Laal, Suman; Ramsay, Andrew; Hopewell, Philip C.; Pai, Madhukar

    2011-01-01

    Background Serological (antibody detection) tests for tuberculosis (TB) are widely used in developing countries. As part of a World Health Organization policy process, we performed an updated systematic review to assess the diagnostic accuracy of commercial serological tests for pulmonary and extrapulmonary TB with a focus on the relevance of these tests in low- and middle-income countries. Methods and Findings We used methods recommended by the Cochrane Collaboration and GRADE approach for rating quality of evidence. In a previous review, we searched multiple databases for papers published from 1 January 1990 to 30 May 2006, and in this update, we add additional papers published from that period until 29 June 2010. We prespecified subgroups to address heterogeneity and summarized test performance using bivariate random effects meta-analysis. For pulmonary TB, we included 67 studies (48% from low- and middle-income countries) with 5,147 participants. For all tests, estimates were variable for sensitivity (0% to 100%) and specificity (31% to 100%). For anda-TB IgG, the only test with enough studies for meta-analysis, pooled sensitivity was 76% (95% CI 63%–87%) in smear-positive (seven studies) and 59% (95% CI 10%–96%) in smear-negative (four studies) patients; pooled specificities were 92% (95% CI 74%–98%) and 91% (95% CI 79%–96%), respectively. Compared with ELISA (pooled sensitivity 60% [95% CI 6%–65%]; pooled specificity 98% [95% CI 96%–99%]), immunochromatographic tests yielded lower pooled sensitivity (53%, 95% CI 42%–64%) and comparable pooled specificity (98%, 95% CI 94%–99%). For extrapulmonary TB, we included 25 studies (40% from low- and middle-income countries) with 1,809 participants. For all tests, estimates were variable for sensitivity (0% to 100%) and specificity (59% to 100%). Overall, quality of evidence was graded very low for studies of pulmonary and extrapulmonary TB. Conclusions Despite expansion of the literature since 2006

  14. "There's No Place Like Home": Perceptions of Home-Based HIV Testing in Lesotho

    ERIC Educational Resources Information Center

    Mantell, J. E.; DiCarlo, A. L.; Remien, R. H.; Zerbe, A.; Morris, D.; Pitt, B.; Nkonyana, J. P.; Abrams, E. J.; El-Sadr, W.

    2014-01-01

    HIV testing has the potential to reduce HIV transmission by identifying and counseling individuals with HIV, reducing risk behaviors, linking persons with HIV to care and earlier treatment, and reducing perinatal transmission. In Lesotho, a high HIV prevalence country in which a large proportion of the population has never tested for HIV,…

  15. "There's No Place Like Home": Perceptions of Home-Based HIV Testing in Lesotho

    ERIC Educational Resources Information Center

    Mantell, J. E.; DiCarlo, A. L.; Remien, R. H.; Zerbe, A.; Morris, D.; Pitt, B.; Nkonyana, J. P.; Abrams, E. J.; El-Sadr, W.

    2014-01-01

    HIV testing has the potential to reduce HIV transmission by identifying and counseling individuals with HIV, reducing risk behaviors, linking persons with HIV to care and earlier treatment, and reducing perinatal transmission. In Lesotho, a high HIV prevalence country in which a large proportion of the population has never tested for HIV,…

  16. HIV-1/HIV-2 co-infection among voluntary counselling and testing subjects at a regional hospital in Cameroon.

    PubMed

    Nsagha, D S; Njunda, A L; Kamga, H L F; Assob, J C N; Bongkem, E A

    2012-09-01

    HIV/AIDS is a major public health problem in Cameroon which had a prevalence of 5.1% in 2010 with 141 new infections per day. The fear of voluntary counseling and testing (VCT) is an obstacle to HIV prevention. To determine the prevalence of HIV-1, HIV-2 and HIV-1/HIV-2 co-infection among people attending a health facility for VCT. Venous blood was collected from participants using aseptic techniques in a descriptive observational cross-sectional study. DETERMINE HIV-1/2 and SD BIOLINE HIV-1/2 3.0 qualitative tests were used for the detection of HIV-1 and HIV-2 in their sera. Range and consistency checks were carried out on the data and analysed using Epi-Info. Of 290 individuals tested, 78(26.9%) were positive for HIV-1 and HIV-2. Among the 78 HIV positive individuals, 62 (79.5%) had HIV-1, 1(1.3%) had HIV-2 and 15(19.2%) had concurrent HIV-1/ HIV-2. Among those infected, 57(73.1%) were females including 21(26.9%) males. HIV-1 is the major cause of AIDS and VCT is well accepted. Co-infection with HIV-1/HIV-2 may lead to anti-retroviral drug resistance. VCT should be encouraged so that positive cases can initiate therapy on time to stay ahead of anti-retroviral drug resistance.

  17. Serology of treponematoses

    PubMed Central

    Rein, Charles R.; Reyn, Alice

    1956-01-01

    In this general review of the serology of the treponematoses and of syphilis in particular, the authors first consider recent technical improvements in the materials used by serological laboratories and in the tests they perform. Special stress is laid on the new tests using treponemal antigens; but it is pointed out that the more commonly used tests should not be discarded in routine testing, the particular value of the newer tests residing in their use on doubtful sera. Mass blood testing—whether as a result of legal requirement and regulation or in the routine testing of patients and industrial workers—is extremely valuable where there is much syphilis among the population tested but becomes very costly when the number of positive reactors found is small. In a section on the clinical implications of serological findings, the authors deal with the problems presented by seropositive pregnant women and newborn children, with quantitative serological tests for syphilis, with the serological response in penicillin-treated syphilis, and with the serology of asymptomatic reinfection and serorelapse. PMID:13329846

  18. 'Men usually say that HIV testing is for women': gender dynamics and perceptions of HIV testing in Lesotho.

    PubMed

    DiCarlo, Abby L; Mantell, Joanne E; Remien, Robert H; Zerbe, Allison; Morris, Danielle; Pitt, Blanche; Abrams, Elaine J; El-Sadr, Wafaa M

    2014-01-01

    In Lesotho, men have lower HIV testing rates, less contact with HIV clinical settings and less knowledge of HIV prevention than women. However, women's HIV prevalence has consistently remained higher than men's. This paper explores gender norms, sexual decision-making and perceptions of HIV among a sample of Basotho men and women in order to understand how these factors influence HIV testing and prevention. A total of 200 women and 30 men were interviewed in Lesotho between April and July 2011. Participants reported reluctance among women to share information about HIV prevention and testing with men, and resistance of men to engage with testing and/or prevention services. Findings demonstrate a critical need for educational initiatives for men, among other strategies, to engage men with HIV testing and prevention. This study highlights how gender issues shape perceptions of HIV and sexual decision-making and underlines the importance of engaging men along with women in HIV prevention efforts. More studies are needed to determine the most effective strategies to inform and engage men.

  19. ‘Men usually say that HIV testing is for women’: Gender dynamics & perceptions of HIV testing in Lesotho

    PubMed Central

    DiCarlo, Abby L.; Mantell, Joanne E.; Remien, Robert H.; Zerbe, Allison; Morris, Danielle; Pitt, Blanche; Abrams, Elaine J.; El-Sadr, Wafaa

    2014-01-01

    In Lesotho, men have lower HIV testing rates, less contact with HIV clinical settings, and less knowledge of HIV prevention than women. However, women’s HIV prevalence has consistently remained higher than men’s. This paper explores gender norms, sexual decision-making, and perceptions of HIV among a sample of Basotho men and women in order to understand how these factors influence HIV testing and prevention. Two hundred women and 30 men were interviewed in Lesotho between April–July 2011. Participants reported reluctance among women to share information about HIV prevention and testing with men, and resistance of men to engage with testing and/or prevention services. Findings demonstrate a critical need for educational initiatives for men, among other strategies to engage men with HIV testing and prevention. This study highlights how gender issues shape perceptions of HIV and sexual decision-making and underlines the importance of engaging men along with women in HIV prevention efforts. More studies are needed to determine the most effective strategies to inform and engage men. PMID:24854495

  20. HIV Testing Trends: Southeastern Pennsylvania, 2002–2010

    PubMed Central

    Yehia, Baligh R.; Harhay, Michael O.; Fetzer, Bradley; Brady, Kathleen A.; Long, Judith A.

    2014-01-01

    Abstract There are limited data on HIV testing trends after 2006 when the Centers for Disease Control and Prevention (CDC) introduced opt-out HIV testing with the aims of identifying HIV-infected persons early and linking them to care. We used data from the Southeastern Pennsylvania Household Health Survey between 2002 and 2010 to evaluate HIV testing over time. 50,698 adult (≥18 years) survey respondents were included. HIV testing increased after the CDC recommendations: 42.1% of survey respondents received testing at least once in 2002 versus 51.4% in 2010, p<0.001. Testing trends increased among all demographic groups, but existing differences in testing before 2006 persisted after that year as follows: younger patients, racial/ethnic minorities, patients on Medicaid were all more likely to get tested than their counterparts. Blacks and patients seeking care in community health centers had the fastest rise in HIV testing. The probability of HIV testing in Blacks was 0.56 (95% CI 0.54–0.60) in 2002 and increased to 0.73 (0.70–0.76) by 2010. Patients seeking care in community health centers had a probability of HIV testing of 0.57 (0.47–0.66) in 2002, which increased to 0.69 (0.60–0.77) by 2010. In comparison, patients in private clinics had an HIV testing probability of 0.40 (0.36–0.43) in 2002 compared to 0.47 (0.40–0.54) in 2010. HIV testing is increasing, particularly among ethnic minorities and in community health centers. However, testing remains to be improved in that setting and across all clinic types. PMID:24742326

  1. Comparison of different commercial serological tests for the detection of Toxoplasma gondii antibodies in serum of naturally exposed pigs.

    PubMed

    Steinparzer, R; Reisp, K; Grünberger, B; Köfer, J; Schmoll, F; Sattler, T

    2015-03-01

    Toxoplasma gondii is the aetiological agent of the zoonotic disease toxoplasmosis and transmitted among other ways by chemically and physically untreated, that is, raw pork to humans. The detection of Toxoplasma gondii is impossible by currently practiced meat inspection, but serological tests can be used to detect Toxoplasma gondii antibodies in pig herds and can consequently be helpful to identify potentially contaminated pork. Therefore, appropriate serological tests are required. In this study, serum samples of 1368 naturally exposed slaughter pigs from 73 Austrian farms were collected. Serum samples of at least 16 slaughter pigs per farm were tested. The prevalence of Toxoplasma gondii antibodies in serum was measured by a commercial available modified agglutination test (MAT) and compared to three different commercial available enzyme-linked immunosorbent assays (ELISA). The MAT detected 6.5%, ELISA I 6.7%, ELISA II 4.8% and ELISA III 4.3% of the pigs as Toxoplasma gondii antibody positive. The agreement, according to the kappa coefficient (κ), was substantial between the MAT and ELISA I (κ = 0.62), II (κ = 0.64) and III (κ = 0.67). A better agreement was determined between ELISA I and II (κ = 0.715), ELISA I and III (κ = 0.747) and ELISA II and III (κ = 0.865). At least one pig per farm was detected Toxoplasma gondii antibody positive in 17 (23.3%) farms by the MAT, 26 (35.6%) farms by ELISA I, 16 (21.9%) farms by ELISA II and 11 (15.1%) farms by ELISA III. Pig farms with a high number of Toxoplasma gondii antibody-positive pigs or high antibody titres were identified by all of the four used serological tests. Concerning the occurrence of Toxoplasma gondii antibodies in Austrian pig farms, a monitoring and surveillance programme would be reasonable to find high-risk farms. © 2014 Blackwell Verlag GmbH.

  2. Knowledge-based interpretation of toxoplasmosis serology test results including fuzzy temporal concepts--the ToxoNet system.

    PubMed

    Kopecky, D; Hayde, M; Prusa, A R; Adlassnig, K P

    2001-01-01

    Transplacental transmission of Toxoplasma gondii from an infected, pregnant woman to the unborn that occurs with a probability of about 60 percent [1] results in fetal damage to a degree depending on the gestational age. The computer system ToxoNet processes the results of serological antibody tests having been performed during pregnancy by means of a knowledge base containing medical knowledge on the interpretation of Toxoplasmosis serology tests. By applying this knowledge ToxoNet generates interpretive reports consisting of a diagnostic interpretation and recommendations for therapy and further testing. For that purpose it matches the results of all serological investigations of maternal blood with the content of the knowledge base returning complete textual interpretations for all given findings. The interpretation algorithm derives the stage of maternal infection from these that is used to infer the degree of fetal threat. To consider varying immune responses of particular patients, certain time intervals have to be kept between two subsequent tests in order to guarantee a correct interpretation of the test results. These time intervals are modelled as fuzzy sets, since they allow the formal description of the temporal uncertainties. ToxoNet comprises the knowledge base, an interpretation system, and a program for the creation and modification of the knowledge base. It is available from the World Wide Web by starting a standard browser like the Internet Explorer or the Netscape Navigator. Thus ToxoNet supports the physician in Toxoplasmosis diagnostics and in addition allows to adopt the way of making decisions to the characteristics of the particular laboratory by modifying the underlying knowledge base.

  3. Dental hygienists' knowledge of HIV, attitudes towards people with HIV and willingness to conduct rapid HIV testing.

    PubMed

    Santella, A J; Krishnamachari, B; Davide, S H; Cortell, M; Furnari, W; Watts, B; Haden, S C

    2013-11-01

    To normalize rapid human immunodeficiency virus (HIV) testing in the United States, expanded rapid HIV testing initiatives are needed outside the routine medical setting. The dental setting is a logical choice as almost two-thirds of Americans regularly see a dental provider each year. This study was aimed to determine the dental hygienists' knowledge of HIV, attitudes towards people living with HIV and willingness to conduct rapid HIV testing. A national cross-sectional survey of practicing dental hygienists and senior dental hygiene students were recruited using state dental hygiene associations, email LISTSERVS, dental hygiene programmes and continuing education conferences (n = 634). The mean knowledge score was 10.5/13. High versus low test-scorers (75% of test questions or more answered correctly versus less than 75% answered correctly) did differ in their comfort level in counselling about sexual HIV prevention methods (P = 0.03) and comfort level in working with medically compromised patients (P = 0.04). Dental hygienists, with additional training in HIV prevention counseling and diagnostic testing, may be an appropriate profession to conduct rapid HIV testing. © 2013 John Wiley & Sons A/S.

  4. Behavioural Precursors and HIV Testing Behaviour among African American Women

    ERIC Educational Resources Information Center

    Uhrig, Jennifer D.; Davis, Kevin C.; Rupert, Doug; Fraze, Jami

    2012-01-01

    Objective: To examine whether there is an association between knowledge, attitudes and beliefs, reported intentions to get an HIV test, and reported HIV testing behaviour at a later date among a sample of African American women. Design: Secondary analysis of data collected from October 2007 through March 2008 for a randomized controlled experiment…

  5. HIV Testing in Recent College Students: Prevalence and Correlates

    ERIC Educational Resources Information Center

    Caldeira, Kimberly M.; Singer, Barbara J.; O'Grady, Kevin E.; Vincent, Kathryn B.; Arria, Amelia M.

    2012-01-01

    Prevalence and correlates of HIV testing were examined in a sample of 957 unmarried recent college students in the United States. Participants were asked about HIV testing, past-six-months sexual activities, lifetime treatment for sexually transmitted infections (STI), past-year health service utilization, and DSM-IV criteria for alcohol and other…

  6. Sexual Orientation Differences in HIV Testing Motivation among College Men

    ERIC Educational Resources Information Center

    Kort, Daniel N.; Samsa, Gregory P.; McKellar, Mehri S.

    2017-01-01

    Objective: To investigate sexual orientation differences in college men's motivations for HIV testing. Participants: 665 male college students in the Southeastern United States from 2006 to 2014. Methods: Students completed a survey on HIV risk factors and testing motivations. Logistic regressions were conducted to determine the differences…

  7. HIV Testing in Recent College Students: Prevalence and Correlates

    ERIC Educational Resources Information Center

    Caldeira, Kimberly M.; Singer, Barbara J.; O'Grady, Kevin E.; Vincent, Kathryn B.; Arria, Amelia M.

    2012-01-01

    Prevalence and correlates of HIV testing were examined in a sample of 957 unmarried recent college students in the United States. Participants were asked about HIV testing, past-six-months sexual activities, lifetime treatment for sexually transmitted infections (STI), past-year health service utilization, and DSM-IV criteria for alcohol and other…

  8. Behavioural Precursors and HIV Testing Behaviour among African American Women

    ERIC Educational Resources Information Center

    Uhrig, Jennifer D.; Davis, Kevin C.; Rupert, Doug; Fraze, Jami

    2012-01-01

    Objective: To examine whether there is an association between knowledge, attitudes and beliefs, reported intentions to get an HIV test, and reported HIV testing behaviour at a later date among a sample of African American women. Design: Secondary analysis of data collected from October 2007 through March 2008 for a randomized controlled experiment…

  9. Behavioral and Psychological Responses to HIV Antibody Testing.

    ERIC Educational Resources Information Center

    Jacobsen, Paul B.; And Others

    1990-01-01

    Considers effects of informing individuals of their antibody status as determined by human immunodeficiency virus (HIV) antibody testing. Reviews research examining changes in psychological distress and in behaviors associated with HIV infections among individuals who have undergone antibody testing. Identifies methodological issues in studying…

  10. Behavioral and Psychological Responses to HIV Antibody Testing.

    ERIC Educational Resources Information Center

    Jacobsen, Paul B.; And Others

    1990-01-01

    Considers effects of informing individuals of their antibody status as determined by human immunodeficiency virus (HIV) antibody testing. Reviews research examining changes in psychological distress and in behaviors associated with HIV infections among individuals who have undergone antibody testing. Identifies methodological issues in studying…

  11. Factors associated with failure to return for HIV test results in a free and anonymous screening centre.

    PubMed

    Laanani, Moussa; Dozol, Adrien; Meyer, Laurence; David, Stéphane; Camara, Sékou; Segouin, Christophe; Troude, Pénélope

    2015-07-01

    Free and anonymous screening centres (CDAG: Centres de Depistage Anononyme et Gratuit) are public facilities set up for HIV infection diagnosis in France. Some people visiting CDAG fail to return for test results and are not informed of their serology. This study aimed to assess factors associated with failure to return for HIV test results. Patients visiting the Fernand-Widal CDAG (Paris) for an HIV test in January-February 2011 were eligible to take part in the study. Data were collected with an anonymous self-administered questionnaire. Factors associated with failure to return were assessed using logistic regression models. Of the 710 participants (participation rate 88%), 46 patients failed to return. Not specifying birthplace and not living in the region of Paris were associated with failure to return. Those who perceived no risk of HIV infection and those who felt they were more at risk than other people were both statistically associated with failure to return. Self-perceived risk seemed to be of chief concern for failure to return for HIV test results and should be considered during pre-test counselling. © The Author(s) 2014.

  12. HIV-1 drug resistance and resistance testing.

    PubMed

    Clutter, Dana S; Jordan, Michael R; Bertagnolio, Silvia; Shafer, Robert W

    2016-12-01

    The global scale-up of antiretroviral (ARV) therapy (ART) has led to dramatic reductions in HIV-1 mortality and incidence. However, HIV drug resistance (HIVDR) poses a potential threat to the long-term success of ART and is emerging as a threat to the elimination of AIDS as a public health problem by 2030. In this review we describe the genetic mechanisms, epidemiology, and management of HIVDR at both individual and population levels across diverse economic and geographic settings. To describe the genetic mechanisms of HIVDR, we review the genetic barriers to resistance for the most commonly used ARVs and describe the extent of cross-resistance between them. To describe the epidemiology of HIVDR, we summarize the prevalence and patterns of transmitted drug resistance (TDR) and acquired drug resistance (ADR) in both high-income and low- and middle-income countries (LMICs). We also review to two categories of HIVDR with important public health relevance: (i) pre-treatment drug resistance (PDR), a World Health Organization-recommended HIVDR surveillance metric and (ii) and pre-exposure prophylaxis (PrEP)-related drug resistance, a type of ADR that can impact clinical outcomes if present at the time of treatment initiation. To summarize the implications of HIVDR for patient management, we review the role of genotypic resistance testing and treatment practices in both high-income and LMIC settings. In high-income countries where drug resistance testing is part of routine care, such an understanding can help clinicians prevent virological failure and accumulation of further HIVDR on an individual level by selecting the most efficacious regimens for their patients. Although there is reduced access to diagnostic testing and to many ARVs in LMIC, understanding the scientific basis and clinical implications of HIVDR is useful in all regions in order to shape appropriate surveillance, inform treatment algorithms, and manage difficult cases. Copyright © 2016 Elsevier B

  13. Evaluation of a Novel Reporter Virus Neutralization Test for Serological Diagnosis of Zika and Dengue Virus Infection.

    PubMed

    Shan, Chao; Ortiz, Daniel A; Yang, Yujiao; Wong, Susan J; Kramer, Laura D; Shi, Pei-Yong; Loeffelholz, Michael J; Ren, Ping

    2017-10-01

    Currently, the laboratory diagnosis of Zika virus (ZIKV) infection is primarily through the detection of ZIKV RNA or antibodies against ZIKV proteins. The detection of viral RNA is highly sensitive and specific, but periods of viremia and viruria are brief, limiting the utility of ZIKV RNA assays. Instead, most ZIKV infections are diagnosed serologically, using an IgM antibody capture enzyme-linked immunosorbent assay (MAC-ELISA) for screening, followed by a confirmatory plaque reduction neutralization test (PRNT). Typical turnaround times vary, due to assay incubation periods and a lack of clinical laboratories performing these tests. Recently, a novel luciferase-ZIKV- and -dengue virus (DENV)-based serological assay, which considerably improves the turnaround times and throughput for ZIKV diagnosis, was described. Using the traditional PRNT as a reference method, we evaluated the performance characteristics of the reporter virus neutralization test (RVNT) with 258 clinical serum specimens. The ZIKV RVNT produced primary ZIKV screening and secondary confirmation results in 4 days, with 100% reproducibility. As a screening assay, the ZIKV RVNT displayed excellent diagnostic accuracy, sensitivity, and specificity of 98.2%, 100%, and 98.1%, respectively. As a confirmatory assay, the ZIKV RVNT titers displayed 93.1% agreement with the traditional ZIKV PRNT titers. Overall, the RVNT accurately and reliably detects neutralizing antibodies in patient serum specimens, with improved turnaround times, and can be used for the serological detection of ZIKV infections. Due to the homogeneous 96-well format, the RVNT has also significantly improved the assay throughput to allow testing of a large number of specimens in a single run. Copyright © 2017 Shan et al.

  14. Retrospective serological study of histoplasmosis in Mexico.

    PubMed

    Taylor, M L; Pedroza-Serés, M; Gámez-Aranda, A; Toriello, C

    1993-01-01

    Mycotic immunodiagnosis was performed in 325 patients with clinical evidence of systemic mycoses, over a 5-year period, from different hospitals of Mexico City. Results showed 168 individuals that presented one positive serological test to Histoplasma capsulatum antigens. From these, only 27 patients were serologically positive to two or more tests, such as tube precipitin, immunodiffusion, complement fixation, and ELISA, and developed signs and symptoms of a histoplasmosis clinically classified as primary pulmonary. Four of them presented an underlying disease including one positive HIV patient. Twenty-two came from endemic histoplasmosis zones of the country and most of them acquired the disease in caves or uninhabited houses. The diagnosis of histoplasmosis should be based on reliable laboratory data which could raise more significant information of its incidence in Mexico.

  15. Is serological testing a reliable tool in laboratory diagnosis of syphilis? Meta-analysis of eight external quality control surveys performed by the german infection serology proficiency testing program.

    PubMed

    Müller, Iris; Brade, Volker; Hagedorn, Hans-Jochen; Straube, Erich; Schörner, Christoph; Frosch, Matthias; Hlobil, Harald; Stanek, Gerold; Hunfeld, Klaus-Peter

    2006-04-01

    The accuracy of diagnostic tests is critical for successful control of epidemic outbreaks of syphilis. The reliability of syphilis serology in the nonspecialist laboratory has always been questioned, but actual data dealing with this issue are sparse. Here, the results of eight proficiency testing sentinel surveys for diagnostic laboratories in Germany between 2000 and 2003 were analyzed. Screening tests such as Treponema pallidum hemagglutination assay (mean accuracy, 91.4% [qualitative], 75.4% [quantitative]), Treponema pallidum particle agglutination assay (mean accuracy, 98.1% [qualitative], 82.9% [quantitative]), and enzyme-linked immunosorbent assays (ELISAs) (mean qualitative accuracy, 95%) were more reliable than Venereal Disease Research Laboratory (VDRL) testing (mean accuracy, 89.6% [qualitative], 71.1% [quantitative]), the fluorescent treponemal antibody absorption test (FTA-ABS) (mean accuracy, 88% [qualitative], 65.8% [quantitative]), and immunoblot assays (mean qualitative accuracy, 87.3%). Clearly, immunoglobulin M (IgM) tests were more difficult to manage than IgG tests. False-negative results for samples that have been unambiguously determined to be IgM and anti-lipoid antibody positive accounted for 4.7% of results in the IgM ELISA, 6.9% in the VDRL test, 18.5% in the IgM FTA-ABS, and 23.0% in the IgM immunoblot assay. For negative samples, the mean percentage of false-positive results was 4.1% in the VDRL test, 5.4% in the IgM ELISA, 0.7% in the IgM FTA-ABS, and 1.4% in the IgM immunoblot assay. On average, 18.3% of participants misclassified samples from patients with active syphilis as past infection without indicating the need for further treatment. Moreover, 10.2% of laboratories wrongly reported serological evidence for active infection in samples from patients with past syphilis or in sera from seronegative blood donors. Consequently, the continuous participation of laboratories in proficiency testing and further standardization of tests

  16. Low HIV testing rates among tuberculosis patients in Kampala, Uganda

    PubMed Central

    2010-01-01

    Background HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to assess the level of HIV test uptake among newly diagnosed pulmonary tuberculosis (PTB) patients; to assess patient and health worker factors associated with HIV test uptake; and to determine factors associated with HIV test uptake at the primary care clinics Methods Adult patients who had been diagnosed with smear-positive PTB at a primary care clinic or at the referral hospital and who were being treated at any of the three clinics were interviewed. Associations between having taken the test as the main outcome and explanatory variables were assessed by multivariate logistic regression. Results Between April and October 2007, 112 adults were included in the study. An HIV test had been offered to 74 (66%). Of the 112 patients, 61 (82%) had accepted the test; 45 (74%) had eventually been tested; and 32 (29%) had received their test results. Patients who were <25 yeas old, female or unemployed, or had reported no previous HIV testing, were more likely to have been tested. The strongest predictor of having been tested was if patients had been diagnosed at the referral hospital compared to the city clinic (adjusted OR 24.2; 95% CI 6.7-87.7; p < 0.001). This primarily reflected an "opt-out" (uptake 94%) versus an "opt-in" (uptake 53%) testing policy. Conclusions The overall HIV test uptake was surprisingly low at 40%. The HIV test uptake was significantly higher among TB patients who were identified at hospital, among females and in the unemployed. PMID:20356353

  17. Low HIV testing rates among tuberculosis patients in Kampala, Uganda.

    PubMed

    Sendagire, Ibrahim; Schreuder, Imke; Mubiru, Mesach; van der Loeff, Maarten Schim; Cobelens, Frank; Konde-Lule, Joseph

    2010-03-31

    HIV testing among tuberculosis patients is critical in improving morbidity and mortality as those found to be HIV positive will be offered a continuum of care including ART if indicated. We conducted a cross-sectional study in three Kampala City primary care clinics: to assess the level of HIV test uptake among newly diagnosed pulmonary tuberculosis (PTB) patients; to assess patient and health worker factors associated with HIV test uptake; and to determine factors associated with HIV test uptake at the primary care clinics Adult patients who had been diagnosed with smear-positive PTB at a primary care clinic or at the referral hospital and who were being treated at any of the three clinics were interviewed. Associations between having taken the test as the main outcome and explanatory variables were assessed by multivariate logistic regression. Between April and October 2007, 112 adults were included in the study. An HIV test had been offered to 74 (66%). Of the 112 patients, 61 (82%) had accepted the test; 45 (74%) had eventually been tested; and 32 (29%) had received their test results.Patients who were <25 yeas old, female or unemployed, or had reported no previous HIV testing, were more likely to have been tested. The strongest predictor of having been tested was if patients had been diagnosed at the referral hospital compared to the city clinic (adjusted OR 24.2; 95% CI 6.7-87.7; p < 0.001). This primarily reflected an "opt-out" (uptake 94%) versus an "opt-in" (uptake 53%) testing policy. The overall HIV test uptake was surprisingly low at 40%. The HIV test uptake was significantly higher among TB patients who were identified at hospital, among females and in the unemployed.

  18. Late HIV testing in a cohort of HIV-infected patients followed in Puerto Rico

    PubMed Central

    Tossas-Milligan, Katherine Y.; Hunter-Mellado, Robert F.; Mayor, Angel M.; Fernandez-Santos, Diana M.; Dworkin, Mark S.

    2016-01-01

    Objective Late HIV testing (LT) defined as an AIDS diagnosis within a year of first positive HIV test is associated with higher HIV transmission, lower HAART effectiveness, and worse outcomes. Latinos represent 36% of LT in the US, yet research concerning LT among HIV cases in Puerto Rico is scarce. Methods Multivariable logistic regression analysis was used to identify factors associated with LT and Cochran-Armitage test to describe LT trends in an HIV infected cohort followed at a specialized HIV clinic in Puerto Rico. Results From 2000 to 2011, 47% of eligible patients were LT, with lower median CD4 count (54 vs. 420 cells/mm3) and higher median HIV viral load counts (253,680 vs. 23,700 copies/mL), when compared to non-LT patients. LT prevalence decreased significantly, from 47% in 2000 to 37% in 2011. In a mutually adjusted logistic regression model, males, older age at enrolment and past history of IDU significantly increased LT odds whereas history of amphetamine use decreased LT odds. Stratified by mode of transmission, only men who have sex with men (MSM), had a significant reduction in the proportion of LT, from 67% in 2000 to 33% in 2011. Conclusion These results suggest a gap in early HIV detection in Puerto Rico that decreased only among MSM. A closer evaluation of HIV testing guideline implementation among non MSM in the Island is needed. PMID:26356739

  19. Strategies to Improve HIV Testing in African Americans

    PubMed Central

    Kenya, Sonjia; Okoro, Ikenna; Wallace, Kiera; Carrasquillo, Olveen; Prado, Guillermo

    2015-01-01

    Only 17% of Miami-Dade County residents are African American, yet this population accounts for 59% of the county’s HIV-related mortality. The Centers for Disease Control and Prevention recommend annual testing for persons at increased risk for HIV, but 40% of African Americans have never been tested. OraQuick®, the first FDA-approved home-based HIV rapid test (HBHRT), has the potential to increase testing rates; however, there are concerns about HBHRT in vulnerable populations. We conducted focus groups in an underserved Miami neighborhood to obtain community input regarding HBHRT as a potential mechanism to increase HIV testing in African Americans. We queried HIV knowledge, attitudes toward research, and preferred intervention methods. Several HIV misconceptions were identified and participants expressed support for HIV research and introducing HBHRT into the community by culturally appropriate individuals trained to provide support. We concluded that community health workers paired with HBHRT were a promising strategy to increase HIV testing in this population. PMID:26066691

  20. Strategies to Improve HIV Testing in African Americans.

    PubMed

    Kenya, Sonjia; Okoro, Ikenna; Wallace, Kiera; Carrasquillo, Olveen; Prado, Guillermo

    2015-01-01

    Only 17% of Miami-Dade County residents are African American, yet this population accounts for 59% of the county's HIV-related mortality. The Centers for Disease Control and Prevention recommend annual testing for persons at increased risk for HIV, but 40% of African Americans have never been tested. OraQuick® (OraSure Technologies, Inc., Bethlehem, PA), the first US Food and Drug Administration-approved home-based HIV rapid test (HBHRT), has the potential to increase testing rates; however, there are concerns about HBHRT in vulnerable populations. We conducted focus groups in an underserved Miami neighborhood to obtain community input regarding HBHRT as a potential mechanism to increase HIV testing in African Americans. We queried HIV knowledge, attitudes toward research, and preferred intervention methods. Several HIV misconceptions were identified, and participants expressed support for HIV research and introducing HBHRT into the community by culturally appropriate individuals trained to provide support. We concluded that community health workers paired with HBHRT were a promising strategy to increase HIV testing in this population.

  1. HIV Stigma and the Experiences of Young Men with Voluntary and Routine HIV Testing

    PubMed Central

    Knight, Rod; Small, Will; Shoveller, Jean A.

    2015-01-01

    As routine HIV testing approaches are implemented to enhance participation rates in HIV testing, it is often widely believed that these approaches are socially and ethically justifiable given the underlying assumption that these practices will result in the widespread reduction of HIV-related stigma. Nonetheless, a variety of empirical and theoretical gaps regarding how HIV testing practices may impact HIV stigma remain, raising questions about the social underpinnings of the public health rationale. We draw on 50 interviews with 18-24-year-old men to determine how HIV-related stigma is experienced differentially across subgroups of young men in relation to both voluntary and routine testing practices. Men's experiences with routine testing highlight how (mis)interpretations of universal, routine testing practices may serve to (unintentionally) burden disadvantaged population subgroups of men; however, when sufficiently explicated, the universal dimension of a routine offer greatly diminished these concerns. These findings also highlight that, under the right conditions, a routine offer can provide transformative opportunities for individuals to reconceptualise expectations pertaining to HIV and HIV-related stigma. PMID:26382632

  2. Quality of HIV laboratory testing in Tanzania: a situation analysis.

    PubMed

    Mfinanga, G S; Mutayoba, B; Mbogo, G; Kahwa, A; Kimaro, G; Mhame, P P; Mwangi, C; Malecela, M N; Kitua, A Y

    2007-01-01

    Tanzania is scaling up prevention, treatment, care and support of individuals affected with HIV. There is therefore a need for high quality and reliable HIV infection testing and AIDS staging. The objective of this study was to assess laboratories capacities of services in terms of HIV testing and quality control. A baseline survey was conducted from December 2004 to February 2005 in 12 laboratories which were conveniently selected to represent all the zones of Tanzania. The questionnaires comprised of questions on laboratory particulars, internal and external quality control for HIV testing and quality control of reagents. Source and level of customer satisfaction of HIV test kits supply was established. Of 12 laboratories, nine used rapid tests for screening and two used rapid tests for diagnosis. In the 12 laboratories, four used double ELISA and five used single ELISA and three did not use ELISA. Confirmatory tests observed were Western Blot in three laboratories, DNA PCR in two laboratories, CD4 counting in seven laboratories, and viral load in two laboratories. Although all laboratories conducted quality control (QC) of the HIV kits, only two laboratories had Standard Operating Procedures (SOPs). Internal and external quality control (EQC) was done at varied proportions with the highest frequency of 55.6% (5/9) for internal quality control (IQC) for rapid tests and EQC for ELISA, and the lowest frequency of 14.3% (1/ 7) for IQC for CD4 counting. None of the nine laboratories which conducted QC for reagents used for rapid tests and none of the five which performed IQC and EQC had SOPs. HIV kits were mainly procured by the Medical Store Department and most of laboratories were not satisfied with the delay in procurement procedures. Most of the laboratories used rapid tests only, while some used both rapid tests and ELISA method for HIV testing. In conclusion, the survey revealed inadequacy in Good Laboratory Practice and poor laboratory quality control process

  3. Low HIV testing among persons who inject drugs—National HIV Behavioral Surveillance, 20 U.S. cities, 2012✩

    PubMed Central

    Cooley, Laura A.; Wejnert, Cyprian; Spiller, Michael W.; Broz, Dita; Paz-Bailey, Gabriela

    2016-01-01

    Introduction Persons who inject drugs (PWID) continue to be disproportionately affected by HIV. HIV testing is key to reducing HIV transmission by increasing awareness of HIV status and linking HIV-positive persons to care. Using data from PWID participating in CDC’s National HIV Behavioral Surveillance (NHBS) system, we examined prevalence of recent HIV testing among PWID by certain characteristics to guide interventions to increase HIV testing. Methods We analyzed NHBS data from PWID 18 years or older recruited via respondent-driven sampling in 20 US cities in 2012. We examined demographic and behavioral factors associated with recent HIV testing (within 12 months before interview) using a Poisson model to calculate adjusted prevalence ratios (aPRs). Results Of 9555 PWID, 53% had recently tested for HIV. In multivariable analysis, HIV testing was more frequent among participants who visited a healthcare provider (aPR 1.50, P < 0.001), participated in alcohol or drug treatment (aPR 1.21, P < 0.001), or received an HIV prevention intervention (aPR 1.26, P < 0.001). HIV testing was also more frequent among participants who received free sterile syringes (aPR 1.12, P < 0.001). Discussion Only half of PWID participating in NHBS in 2012 reported recent HIV testing. HIV testing was more frequent among participants who accessed health and HIV prevention services. To increase HIV testing among PWID, it is important for providers in healthcare and HIV prevention settings to proactively assess risk factors for HIV, including injection drug use, and offer a wide range of appropriate interventions, such as HIV testing. PMID:27323649

  4. Using a Multitest Algorithm to Improve the Positive Predictive Value of Rapid HIV Testing and Linkage to HIV Care in Nonclinical HIV Test Sites

    PubMed Central

    Delaney, Kevin P.; Rurangirwa, Jacqueline; Facente, Shelley; Dowling, Teri; Janson, Mike; Knoble, Thomas; Vu, Annie; Hu, Yunyin W.; Kerndt, Peter R.; King, Jan; Scheer, Susan

    2016-01-01

    Background Use of a rapid HIV testing algorithm (RTA) in which all tests are conducted within one client appointment could eliminate off-site confirmatory testing and reduce the number of persons not receiving confirmed results. Methods An RTA was implemented in 9 sites in Los Angeles and San Francisco; results of testing at these sites were compared with 23 sites conducting rapid HIV testing with off-site confirmation. RTA clients with reactive results on more than 1 rapid test were considered HIV+ and immediately referred for HIV care. The positive predictive values (PPVs) of a single rapid HIV test and the RTA were calculated compared with laboratory-based confirmatory testing. A Poisson risk regression model was used to assess the effect of RTA on the proportion of HIV+ persons linked to HIV care within 90 days of a reactive rapid test. Results The PPV of the RTA was 100% compared with 86.4% for a single rapid test. The time between testing and receipt of RTA results was on average 8 days shorter than laboratory-based confirmatory testing. For risk groups other than men who had sex with men, the RTA increased the probability of being in care within 90 days compared with standard testing practice. Conclusions The RTA increased the PPV of rapid testing to 100%, giving providers, clients, and HIV counselors timely information about a client’s HIV-positive serostatus. Use of RTA could reduce loss to follow-up between testing positive and confirmation and increase the proportion of HIV-infected persons receiving HIV care. PMID:26284530

  5. High HIV prevalence, suboptimal HIV testing, and low knowledge of HIV-positive serostatus among injection drug users in St. Petersburg, Russia.

    PubMed

    Niccolai, Linda M; Toussova, Olga V; Verevochkin, Sergei V; Barbour, Russell; Heimer, Robert; Kozlov, Andrei P

    2010-08-01

    The purpose of this analysis was to estimate human immunodeficiency virus (HIV) prevalence and testing patterns among injection drug users (IDUs) in St. Petersburg, Russia. HIV prevalence among 387 IDUs in the sample was 50%. Correlates of HIV-positive serostatus included unemployment, recent unsafe injections, and history/current sexually transmitted infection. Seventy-six percent had been HIV tested, but only 22% of those who did not report HIV-positive serostatus had been tested in the past 12 months and received their test result. Correlates of this measure included recent doctor visit and having been in prison or jail among men. Among the 193 HIV-infected participants, 36% were aware of their HIV-positive serostatus. HIV prevalence is high and continuing to increase in this population. Adequate coverage of HIV testing has not been achieved, resulting in poor knowledge of positive serostatus. Efforts are needed to better understand motivating and deterring factors for HIV testing in this setting.

  6. HIV Testing, Subjective Beliefs and Economic Behavior

    PubMed Central

    Thornton, Rebecca L.

    2013-01-01

    This paper examines the effects of learning HIV status on economic behavior among rural Malawians. According to economic life-cycle models, if learning HIV results is informative about additional years of life, being diagnosed HIV-positive or negative should predict changes in consumption, investment and savings behavior with important micro and macro-economic implications. Using an experiment that randomly assigned incentives to learn HIV results, I find that while learning HIV results had short term effects on subjective belief of HIV infection, these differences did not persist after two years. Consistent with this, there were relatively few differences two years later in savings, income, expenditures, and employment between those who learned and did not learn their status. PMID:24369439

  7. [Return for HIV test results after voluntary screening in Cameroon].

    PubMed

    Ngangue, Patrice-Alain; Gagnon, Marie-Pierre; Bedard, Emmanuelle

    2016-01-01

    Aim: The purpose of this study was to identify beliefs, perceptions and attitudes that may influence the return for test results after voluntary HIV testing in six district hospitals of the city of Douala in Cameroon.Methods: A qualitative study based on theory of planned behaviour (TPB) and using semi-structured interviews (N = 33) was conducted among individuals who underwent a voluntary HIV test in the prevention and voluntary testing and counselling centres (PVTCCs) located in six district hospitals of the city of Douala in Cameroon.Results: Participants identified a) seven advantages to return for their results (e.g., “knowing about my health condition,” “take the medication in the case of a positive result “and four disadvantages (e.g., fear of positive result); b) four groups of people that may influence their decision to return for HIV test results (e.g., family, friends/colleagues; c) one barrier (lack of time) and four factors that can facilitate return for the results after an HIV testing (e.g., the career project).Conclusion: The results of this study indicate that individuals who voluntarily undergo an HIV test in PVTCCs of the Douala district hospitals in Cameroon perceived real advantages and very few disadvantages and barriers to know their HIV status. Particular attention should be given to organizational factors that may be responsible for failure to return for HIV test results and post-test counselling.

  8. Serologic and genotypic characterization of hepatitis B virus in HIV-1 infected patients from South West and Littoral Regions of Cameroon.

    PubMed

    Magoro, Tshifhiwa; Gachara, George; Mavhandu, Lufuno; Lum, Emmaculate; Kimbi, Helen K; Ndip, Roland N; Bessong, Pascal

    2016-10-21

    HBV and HIV share similar transmission routes. Concurrent infection with the two viruses usually results in more severe and progressive liver disease, and a higher incidence of cirrhosis, liver cancer and mortality. Further, this co-infection may lead to cross-resistance between HIV and HBV drugs and increased liver injury, either due to direct hepatotoxicity or drug-related immune-reconstitution hepatitis. These challenges necessitate continuous surveillance for HBV among HIV infected individuals to guide patient management. We conducted this study to understand the serologic and genotypic characteristics of HBV among HIV/HBV infected patients in South West and Littoral Regions of Cameroon. Plasma samples were screened for HBsAg, HBeAg, Anti-HBs and anti-HBc using ELISA followed by DNA extraction from all HBsAg positive samples. A 366 bp region covering the overlapping surface/polymerase gene was amplified by a nested PCR and the product sequenced using Big Dye sequencing chemistry. The resulting sequences were then analyzed for genotypes and both escape and drug resistance mutations. Of the 455 samples in this study, 25.5 % (n = 116) were HBsAg positive and 46 of these had their DNA successfully amplified. Genotype E was found in 32 samples (69.6 %) and genotype A in the rest of the samples. Escape mutations associated with failure of diagnosis (Y100C, R122K and Q129H) and with vaccine escape (Q129R and T131N) were detected in varying frequencies in the population. Polymerase mutations implicated in resistance to lamivudine and other ʟ-nucleoside analogues were detected in seven patients (15.2 %), while all the samples lacked mutations associated with resistance to adefovir and tenofovir. These findings suggest the endemicity of HBV and the predominance of genotypes A and E in the study population. Also, drug resistance findings support the use of tenofovir based ART regimens among HIV/HBV co-infected persons. There is need for continuous HBV screening

  9. HIV Status among Patients with Tuberculosis and HIV Testing Practices by Connecticut Health Care Providers

    PubMed Central

    Clark, Ian T.; Lobato, Mark N.; Gutierrez, Jesus; Sosa, Lynn E.

    2016-01-01

    Knowing the human immunodeficiency virus (HIV) status of persons infected with Mycobacterium tuberculosis is important for individual treatment and preventing transmission. This evaluation analyzed surveillance data and surveyed health care providers who care for patients with HIV and tuberculosis (TB) to understand the factors contributing to suboptimal levels of Connecticut patients with TB having a known HIV status. During 2008 to 2010, 208 (76.2%) of 273 patients had a known HIV status; 12 (5.8%) were HIV-positive. Patients who were more likely to have a known HIV status were younger (40.5 vs 54.6 years, P < .001) or received care in a TB clinic (risk ratio, 1.26; 95% confidence interval, 1.12–1.42). Among 77 providers, 48 (62.3%) completed the survey, 42 (87.5%) reported routinely offering HIV testing to patients with TB, and 26 (54.2%) reported routinely offering HIV testing to patients with latent TB infection (LTBI). We conclude that interventions for improving HIV testing should focus on non-TB clinic providers and patients with LTBI. PMID:23442493

  10. Repeat HIV Testing at Voluntary Testing and Counseling Centers in Croatia: Successful HIV Prevention or Failure to Modify Risk Behaviors?

    PubMed Central

    Matković Puljić, Vlatka; Kosanović Ličina, Mirjana Lana; Kavić, Marija; Nemeth Blažić, Tatjana

    2014-01-01

    HIV testing plays a critical role in preventing the spread of the virus and identifying infected individuals in need of care. Voluntary counseling and testing centers (VCTs) not only conduct testing but they also provide counseling. Since a proportion of people who test negative for HIV on their previous visit will return for retesting, the frequency of retesting and the characteristics of those who retest may provide insights into the efficacy of testing and counseling strategies. In this cross-sectional, retrospective study of 1,482 VCT clients in Croatia in 2010, 44.3% had been tested for HIV before. The rate of repeat HIV testing is lower in Croatia than in other countries. Men who have sex with men (MSM) clients, those with three or more sexual partners in the last 12 months, consistent condom users with steady partners, and intravenous drug users were more likely to be repeat testers. This finding suggests that clients presenting for repeat HIV testing are those who self-identify as being at a higher risk of infection. Our data showed that testing positive for HIV was not associated with repeat testing. However, the effects of repeat testing on HIV epidemiology needs to be explored. PMID:24705595

  11. Detection of Toxoplasma gondii DNA in horse meat from supermarkets in France and performance evaluation of two serological tests

    PubMed Central

    Aroussi, Abdelkrim; Vignoles, Philippe; Dalmay, François; Wimel, Laurence; Dardé, Marie-Laure; Mercier, Aurélien; Ajzenberg, Daniel

    2015-01-01

    In France, some cases of severe toxoplasmosis have been linked to the consumption of horse meat that had been imported from the American continent where atypical strains of Toxoplasma gondii are more common than in Europe. Many seroprevalence studies are presented in the literature but risk assessment of T. gondii infection after horse meat consumption is not possible in the absence of validated serological tests and the unknown correlation between detection of antibodies against T. gondii and presence of tissue cysts. We performed magnetic-capture polymerase chain reaction (MC-PCR) to detect T. gondii DNA in 231 horse meat samples purchased in supermarkets in France and evaluated the performance and level of agreement of the modified agglutination test (MAT) and enzyme-linked immunosorbent assay (ELISA) in the meat juices. The serological tests lacked sensitivity, specificity, and agreement between them, and there was no correlation with the presence of T. gondii DNA in horse meat, raising concerns about the reliability of T. gondii seroprevalence data in horses from the literature. T. gondii DNA was detected in 43% of horse meat samples but the absence of strain isolation in mice following inoculation of more than 100 horse meat samples suggests a low distribution of cysts in skeletal muscles and a low risk of T. gondii infection associated with horse meat consumption. However, to avoid any risk of toxoplasmosis, thorough cooking of horse meat is recommended. PMID:25809058

  12. SEROLOGIC SURVEY AND RESULTS OF URINARY PCR TESTING FOR LEPTOSPIROSIS IN CAPTIVE BLACK-TAILED PRAIRIE DOGS (CYNOMYS LUDOVICIANUS).

    PubMed

    Olds, June E; Sun, Yaxuan; Baum, David H; Gauger, Phillip

    2015-12-01

    Leptospirosis is an important zoonotic disease occurring clinically and subclinically in humans and a wide variety of mammal species worldwide. Often, rodents and wild animals are identified as important reservoirs for the disease. Twenty-two captive black-tailed prairie dogs (Cynomys ludovicianus) housed within a zoo were examined as part of a routine census and preventive medicine program. During examinations, blood and urine were collected to screen for exposure to, or infection with, leptospirosis. All animals were apparently healthy at the time of examination. Leptospira microscopic agglutination test identified 12 of 22 (54.5%) prairie dogs with antibody titers ≥1 : 100 against Leptospira interrogans serovar bratislava on initial serologic examination. All prairie dogs within this collection were serologically negative for L. interrogans serovars canicola, hardjo, icterohaemorrhagiae, and pomona and Leptospira kirschneri serovar grippotyphosa. Leptospira polymerase chain reaction (PCR) testing of urine was negative in all animals tested. This report describes evidence that captive prairie dogs may be exposed to leptospirosis, most likely from wild rodent reservoirs; however, serum titers are low, and lack of leptospiral DNA detected by PCR indicates that these captive animals are unlikely to be important reservoirs for the disease.

  13. Test performance of three serological assays for the detection of Mycobacterium bovis infection in common warthogs (Phacochoerus africanus).

    PubMed

    Roos, Eduard O; Buss, Peter; de Klerk-Lorist, Lin-Mari; Hewlett, Jennie; Hausler, Guy A; Rossouw, Leana; McCall, Alicia J; Cooper, David; van Helden, Paul D; Parsons, Sven D C; Miller, Michele A

    2016-12-01

    Sporadic cases of bovine tuberculosis (bTB) have been reported in warthogs in Southern Africa and confirmed through mycobacterial culture. However, there are no validated ante-mortem tests currently available for bTB in warthogs. In this study, we evaluated the use of three serological assays for the detection of Mycobacterium bovis infection in warthogs; an indirect enzyme-linked immunosorbent assay (ELISA) using bovine purified protein derivative (PPDb) as a capture antigen (indirect PPD ELISA), as well as two commercial assays, the TB ELISA-VK(®) and DPP(®) VetTB Assay. Test performance of these assays was compared using sera from 35 warthogs of known Mycobacterium bovis infection status. All three assays were able to distinguish M. bovis-infected from uninfected individuals with high sensitivity (Se) and specificity (Sp) (indirect PPD ELISA Se: 88%, Sp: 89%; TB ELISA-VK(®) 88%, 79%; DPP(®) VetTB Assay 75%, 89%, respectively). The assays performed very similarly and the ELISA assays showed the greatest agreement (κ=0.89). These results indicate that M. bovis-infected warthogs develop measurable pathogen-specific humoral responses which can be used to distinguish them from uninfected animals. Therefore, serological assays have value as ante-mortem bTB diagnostic tests in warthogs. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Testing in the HIV Counselling and Testing (HCT) campaign, HIV risk behaviours and ART enrolment in South Africa.

    PubMed

    Onoya, D; Mohlabane, N; Maduna, V; van Zyl, J; Sewpaul, R; Naidoo, Y

    2016-07-01

    To examine the association between testing in the 2010 HIV Testing and Counselling (HCT) campaign with HIV risk behaviours and enrolment on ART. Data for this study were collected as part of a nationally representative cross-sectional household survey conducted in 2012 in South Africa. Consenting participants completed a structured questionnaire and provided a dry blood spot specimen which was tested for HIV antibodies and antiretroviral drugs. Multinomial logistic regression was used to examine the association between HIV testing history and explanatory variables of interest. There was no association between testing in the 2010 HCT campaign and condom use at last sex, number of sexual partnerships or HIV knowledge. Individuals who tested in the HCT campaign were more likely to disclose their status (COR 2.6, 95% CI: 1.71-3.8) and those who tested HIV positive in the campaign were more likely to be receiving ART (COR 1.8, 95% CI: 1.1-2.9). Testing in the HCT campaign was associated with having received both pretest and post-test counselling while testing before the campaign was associated with having received HIV results with no counselling (COR 2.1, 95% CI: 1.2-3.8). We highlight the success of the 2010 HCT campaign in improving HIV status disclosure and enrolment on ART as well as shortcomings on HIV risk behaviours and HIV knowledge. These may be related to issues of quality assurance in the counselling process. Our results further highlight possible HCT counselling inconsistencies across sectors requiring stronger public-private partnership in the delivery of HCT in South Africa. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  15. Correlates of HIV testing among abused women in South Africa.

    PubMed

    Adams, Julie L; Hansen, Nathan B; Fox, Ashley M; Taylor, Baishakhi B; van Rensburg, Madri Jansen; Mohlahlane, Rakgadi; Sikkema, Kathleen J

    2011-08-01

    Gender-based violence increases a woman's risk for HIV but little is known about her decision to get tested. We interviewed 97 women seeking abuse-related services from a nongovernmental organization (NGO) in Johannesburg, South Africa. Forty-six women (47%) had been tested for HIV. Caring for children (odds ratio [OR] = 0.27, 95% confidence interval [CI] = [0.07, 1.00]) and conversing with partner about HIV (OR = 0.13, 95% CI = [0.02, 0.85]) decreased odds of testing. Stronger risk-reduction intentions (OR = 1.27, 95% CI = [1.01, 1.60]) and seeking help from police (OR = 5.51, 95% CI = [1.18, 25.76]) increased odds of testing. Providing safe access to integrated services and testing may increase testing in this population. Infection with HIV is highly prevalent in South Africa where an estimated 16.2% of adults between the ages of 15 and 49 have the virus. The necessary first step to stemming the spread of HIV and receiving life-saving treatment is learning one's HIV serostatus through testing. Many factors may contribute to someone's risk of HIV infection and many barriers may prevent testing. One factor that does both is gender-based violence.

  16. [HIV-test policy for tuberculosis patients in the Netherlands].

    PubMed

    Haar, C H; Cobelens, F G J; Kalisvaart, N A; van der Have, J J; van Deutekom, H

    2007-12-01

    To compare the proportion of tuberculosis patients tested for HIV infection, before and after introduction of highly active antiretroviral therapy (HAART) in the Netherlands, and to analyse predictive factors for performing an HTV-test in this population. Retrospective. Whether patients had been tested for HIV, was investigated in random samples consisting of 200 patients, who were registered in the Netherlands Tuberculosis Register (NTR) in the years 1995 and 2001 respectively. The number of patients tested for HIV was 29 out of 84 (16%) in 1995, and 39 out of 190 (21%) in 2001 (not significant). HIV-tests had been carried out most frequently among homeless patients (71%), drug addicts (56%) and alcohol-abusing patients (60%). Significant predictive factors for HIV testing were place of residence (city), localisation of disease (pulmonary tuberculosis in combination with extrapulmonary tuberculosis) and place of origin (sub-Saharan Africa). Despite introduction of HAART during this period, in the Netherlands the proportion of tuberculosis patients tested for HIV did not significantly increase between 1995 and 2001. HIV testing was mainly limited to tuberculosis patients from risk groups.

  17. Correlates of HIV Testing Among Abused Women in South Africa

    PubMed Central

    Adams, Julie L.; Hansen, Nathan B.; Fox, Ashley M.; Taylor, Baishakhi B.; van Rensburg, Madri Jansen; Mohlahlane, Rakgadi; Sikkema, Kathleen J.

    2012-01-01

    Gender-based violence increases a woman’s risk for HIV but little is known about her decision to get tested. We interviewed 97 women seeking abuse-related services from a nongovernmental organization (NGO) in Johannesburg, South Africa. Forty-six women (47%) had been tested for HIV. Caring for children (odds ratio [OR] = 0.27, 95% confidence interval [CI] = [0.07, 1.00]) and conversing with partner about HIV (OR = 0.13, 95% CI = [0.02, 0.85]) decreased odds of testing. Stronger risk-reduction intentions (OR = 1.27, 95% CI = [1.01, 1.60]) and seeking help from police (OR = 5.51, 95% CI = [1.18, 25.76]) increased odds of testing. Providing safe access to integrated services and testing may increase testing in this population. Infection with HIV is highly prevalent in South Africa where an estimated 16.2% of adults between the ages of 15 and 49 have the virus. The necessary first step to stemming the spread of HIV and receiving life-saving treatment is learning one’s HIV serostatus through testing. Many factors may contribute to someone’s risk of HIV infection and many barriers may prevent testing. One factor that does both is gender-based violence. PMID:21727154

  18. HIV and Hepatitis Testing: Global Progress, Challenges, and Future Directions.

    PubMed

    Easterbrook, Philippa; Johnson, Cheryl; Figueroa, Carmen; Baggaley, Rachel

    2016-01-01

    HIV infection and viral hepatitis due to HBV and HCV infection are major causes of chronic disease worldwide, and share some common routes of transmission, epidemiology, initial barriers faced in treatment access, and in strategies for a global public health response. Testing and diagnosis of HIV, HBV, and HCV infection is the gateway for access to both care and treatment and prevention services, and crucial for an effective HIV and hepatitis epidemic response. In this review article, we first summarize the common goals and guiding principles in a public health approach to HIV and hepatitis testing. We summarize the impressive global progress in HIV testing scale-up and evolution of approaches, with expansion of provider-initiated testing and counseling in clinical settings (particularly antenatal and tuberculosis clinics), the introduction of more community based testing services, and use of rapid diagnostic tests enabling provision of same-day test results. However, 46% of all people living with HIV are still unaware of their serostatus, and many continue to be diagnosed and start antiretroviral therapy late. As testing and treatment scale-up accelerates for an "treat all" approach, other challenges to address include how to better focus testing and reach those yet undiagnosed and most at risk, especially key populations, men, adolescents, and children. We summarize future directions in HIV testing to speed scale-up and close gaps that are addressed in the WHO 2015 consolidated HIV testing guidelines. In contrast to HIV, action in hepatitis testing and treatment has been fragmented and limited to a few countries, and there remains a large burden of undiagnosed cases globally. We summarize key challenges in the hepatitis testing response, including lack of simple, reliable, and low-cost diagnostic tests, laboratory capacity, and testing facilities; inadequate data to guide country specific hepatitis testing approaches and who to screen; stigmatization and social

  19. HIV test eliminates wait, but physicians not using it.

    PubMed

    1995-05-01

    The ten-minute SUDS HIV-1 test could make post-test HIV counseling easier and alleviate the problem of patients not returning for their results. Primary care settings, however, are not using the test. Although used in many acute-care facilities, most physicians are not interested in it, partly due to the cost of the test. Similar to pregnancy tests, SUDS can detect HIV antibodies in blood within ten minutes and uses a color bar to show reactivity. A laboratory is needed to conduct the test, and most primary care physician's offices do not have one. In addition, most people who get tested for HIV in private settings return for their results and can be easily contacted; although CDC studies have shown that as many as forty percent of patients tested in public HIV test sites never return for their results. But another CDC study showed that patients who received the SUDS HIV test and were given unconfirmed positive results also were more likely to come back for a confirmatory Western blot test. SUDS, manufactured by Murex Corporation of Norcross, GA, has a sensitivity rate approaching 100 percent and less than 3 out of 1,000 tests are false positive. However, accuracy is adversely affected by inadequate specimen preparation and temperature.

  20. Performances of Four Helicobacter pylori Serological Detection Kits Using Stool Antigen Test as Gold Standard

    PubMed Central

    2016-01-01

    The aim was to determine the performances of four Helicobacter pylori serological detection kits in different target groups, using Amplified IDEIA™ Hp StAR™ as gold standard. Kits studied were Rapid Immunochromatoghraphic Hexagon, Helicoblot 2.1, an EIA IgG kit and EIA IgA kit. Methods: Stool and blood samples were collected from 162 apparently healthy participants (control) and 60 Type 2 diabetes mellitus (T2DM) patients. Results: The performances of the four serological detection kits were found to be affected by gender, age, health status and ethnicity of the participants. In the control group, the Helicoblot 2.1 kit had the best performance (AUC = 0.85; p<0.05, accuracy = 86.4%), followed by EIA IgG (AUC = 0.75; p<0.05, accuracy = 75.2%). The Rapid Hexagon and EIA IgA kits had relatively poor performances. In the T2DM subgroup, the kits H2.1 and EIA IgG had best performances, with accuracies of 96.5% and 93.1% respectively. The performance of EIA IgG improved with adjustment of its cut-off value. Conclusion: The performances of the detection kits were affected by various factors which should be taken into consideration. PMID:27736910

  1. Predictors of First Follow-Up HIV Testing for Couples’ Voluntary HIV Counseling and Testing in Ndola, Zambia

    PubMed Central

    Czaicki, Nancy L; Davitte, Jonathan; Siangonya, Bella; Kastner, Randee; Ahmed, Nurilign; Khu, Naw Htee; Kuo, Wan Hsuan; Abdallah, Joseph; Wall, Kristin M; Tichacek, Amanda; Inambao, Mubiana; Simpungwe, Kakungu; Thior, Ibou; Allen, Susan

    2014-01-01

    Introduction We describe predictors of first follow-up testing for concordant negative and discordant couples seeking joint voluntary HIV counseling and testing in Ndola, Zambia, where cohabiting couples account for an estimated two-thirds of incident HIV infections. Methods Demographic and serostatus data were collected from couples’ voluntary HIV testing and counseling (CVCT) and follow-up testing services implemented in government clinics. We calculated follow-up testing rates by serostatus and compared rates before and after the introduction of a Good Health Package (GHP). Results The follow-up testing rate from May 2011 to December 2012 was 12.2% for concordant negative (M−F−) couples and 24.5% for discordant (M+F− or M−F+) couples. Significant predictors of follow-up testing in multivariate analyses included increasing man’s (aOR=1.02 per year) and woman’s (aOR=1.02) age, the man being HIV+ (aOR=2.57), and the woman being HIV+ (aOR=1.89). The man (aOR=1.29) and the couple (aOR=1.22) having been previously tested for HIV were predictive of follow-up testing among concordant negative couples. Introduction of a GHP increased follow-up testing among discordant (aOR=2.93) and concordant negative (aOR=2.06) couples. Conclusion A low-cost GHP including prevention, screening, and treatment for common causes of morbidity and mortality resulted in increased follow-up testing rates among HIV discordant and concordant negative couples. Overall follow-up testing rates remain low and efforts to increase these rates are necessary in order to ensure linkage to combination prevention, reduce HIV transmission within couples and identify seroconversions promptly. Further investigation of low-cost sustainable incentives and other factors influencing follow-up HIV testing for couples is needed. PMID:24326600

  2. People who Inject Drugs, HIV Risk, and HIV Testing Uptake in Sub-Saharan Africa

    PubMed Central

    Asher, Alice K.; Hahn, Judith A.; Couture, Marie-Claude; Maher, Kelsey; Page, Kimberly

    2013-01-01

    Dramatic rises in injection drug use (IDU) in sub-Saharan Africa account for increasingly more infections in a region already overwhelmed by the HIV epidemic. There is no known estimate of the number of people who inject drugs (PWID) in the region, or the associated HIV prevalence in PWID. We reviewed literature with the goal of describing high-risk practices and exposures in PWID in sub-Saharan Africa, as well as current HIV prevention activities aimed at drug use. The literature search looked for articles related to HIV risk, injection drug users, stigma, and HIV testing in sub-Saharan Africa. This review found evidence demonstrating high rates of HIV in IDU populations in sub-Saharan Africa, high-risk behaviors of the populations, lack of knowledge regarding HIV, and low HIV testing uptake. There is an urgent need for action to address IDU in order to maintain recent decreases in the spread of HIV in sub-Saharan Africa. PMID:23164598

  3. HIV testing behaviors and attitudes after adoption of name-to-code HIV case surveillance in Washington State.

    PubMed

    Hopkins, Sharon G; Gelfand, Sarah E; Buskin, Susan E; Kent, James B; Kahle, Erin M; Barkan, Susan E

    2005-01-01

    Controversy over HIV reporting in Washington State raised concerns that name-to-code reporting might reduce HIV testing. We assessed HIV testing and the influence of reporting among people at risk for HIV. An anonymous survey was conducted 9 months after HIV reporting began. Recruitment for men who have sex with men was at bars; high-risk heterosexuals at a sexually transmitted disease clinic; and injection drug users at needle exchange sites. Eighty-nine percent of 267 participants had been tested for HIV at least once but only half reported testing regularly. Injection drug users and men who have sex with men were more likely than HRH to report regular testing. Main reasons for delaying testing were thinking that HIV exposure was unlikely or not wanting to think about being HIV positive; concern about government reporting was cited by only 2%. Over half the respondents hadn't heard about the new name-to-code HIV reporting mechanism, although 69% thought there was some type of HIV reporting. Only 18% correctly identified the mechanism of HIV reporting. HIV prevention programs should focus on the most common reasons for delaying or avoiding HIV testing: believing that one has not been exposed to HIV, and the fear of learning that one is HIV positive.

  4. Extending Rhetorical-Cultural Analysis: Transformations of Home HIV Testing.

    ERIC Educational Resources Information Center

    Scott, J. Blake

    2003-01-01

    Seeks to extend the work of Rosteck, Bazerman, Condit, and others by further elaborating what a hybrid rhetorical-cultural study might look like. Studies the rhetorics surrounding HIV and AIDS, particularly home HIV testing. Focuses on the rhetoric of science and technology because of its cross-disciplinary nature and its potential to contribute…

  5. Intimate partner violence, consenting to HIV testing and HIV status among Zambian women.

    PubMed

    Nelson, Kara A; Ferrance, Jacquelyn L; Masho, Saba W

    2016-09-01

    Sub-Saharan African countries are heavily burdened with HIV, which disproportionately affects women of reproductive age. Extant literature is inconsistent regarding the link between intimate partner violence and HIV. Data from the 2007 Zambian Demographic Health Survey of women aged 15-49 (n = 5014) were analysed. The influence of abuse by a current or former husband on consent to HIV testing and HIV positivity were evaluated. The unadjusted analysis showed a statistically significant association between intimate partner violence and consent to testing for HIV. Stratified analysis showed that there was a statistically significant association between intimate partner violence and HIV testing in rural areas but not in urban areas. However, the association lost its significance when adjusted for confounding factors. No statistically significant association was found between intimate partner violence and HIV-positive status. It is encouraging that women who experienced intimate partner were testing for HIV. Prevention efforts should continue addressing the needs of this population. © The Author(s) 2015.

  6. Prevalence and Correlates of HIV Infection and HIV Testing Among Transgender Women in Jamaica.

    PubMed

    Logie, Carmen H; Lacombe-Duncan, Ashley; Wang, Ying; Jones, Nicolette; Levermore, Kandasi; Neil, Ava; Ellis, Tyrone; Bryan, Nicolette; Harker, Sheldon; Marshall, Annecka; Newman, Peter A

    2016-09-01

    Transgender women are overrepresented in the Caribbean HIV epidemic. The study objective was to examine correlates of HIV infection and HIV testing among transgender women in Jamaica. We implemented a cross-sectional survey with transgender women in Kingston and Ocho Rios, Jamaica. We conducted multivariable logistic regression to identify factors associated with HIV testing and HIV infection. Among 137 transgender women [mean age 24.0; standard deviation (SD) 5.5], three-quarters (n = 103, 75.7%) had received an HIV test. Of these, one-quarter (n = 26, 25.2%) were HIV positive. In multivariable analyses, HIV testing was associated with: perceived HIV risk [adjusted odds ratio (AOR) 2.42, confidence interval (CI) 1.36-4.28], depression (AOR 1.34, CI 1.01-1.77), forced sex (AOR 3.83, CI 1.42-10.35), physical abuse (AOR 4.11, CI 1.44-11.72), perceived transgender stigma (AOR 1.23, 1.06-1.42), having a healthcare provider (AOR 5.89, CI 1.46-23.77), and lower HIV-related stigma (AOR 0.96, CI 0.92-0.99), incarceration (AOR 0.28, CI 0.10-0.78), and drug use (AOR 0.74, CI 0.58-0.95). HIV infection was associated with the following: homelessness (AOR 5.94, CI 1.27-27.74), perceived HIV risk (AOR 1.67, CI 1.02-2.72), depression (AOR 1.39, CI 1.06-1.82), STI history (AOR 56.79, CI 5.12-630.33), perceived (AOR 1.26, CI 1.06-1.51) and enacted (AOR 1.16, CI 1.04-1.29) transgender stigma, forced sex (AOR 4.14, CI 1.49-11.51), physical abuse (AOR 3.75, CI 1.39-10.12), and lower self-rated health (AOR 0.55, CI 0.30-0.98) and social support (AOR 0.79, CI 0.64-0.97). Transgender women in Jamaica experience high HIV infection rates and suboptimal HIV testing. Combination HIV prevention approaches should address transgender women's social and structural vulnerabilities.

  7. Determinants and Prevalence of Late HIV Testing in Tijuana, Mexico

    PubMed Central

    Carrizosa, Claudia M.; Hovell, Melbourne F.; Martinez-Donate, Ana P.; Garcia-Gonzalez, Gregorio; Lozada, Remedios; Kelley, Norma J.; Hofstetter, C. Richard; Sipan, Carol L.

    2010-01-01

    Abstract Timely diagnosis of HIV is essential to improve survival rates and reduce transmission of the virus. Insufficient progress has been made in effecting earlier HIV diagnoses. The Mexican border city of Tijuana has one of the highest AIDS incidence and mortality rates in all of Mexico. This study examined the prevalence and potential correlates of late HIV testing in Tijuana, Mexico. Late testers were defined as participants who had at least one of: (1) an AIDS-defining illness within 1 year of first positive HIV test; (2) a date of AIDS diagnosis within 1 year of first positive HIV test; or (3) an initial CD4 cell count below 200 cells per microliter within 1 year of first positive HIV test. Medical charts of 670 HIV-positive patients from two HIV/AIDS public clinics in Tijuana were reviewed and abstracted; 362 of these patients were interviewed using a cross-sectional survey. Using multivariate logistic regression, we explored potential correlates of late HIV testing based on the Behavioral Ecological Model. From 342 participants for whom late testing could be determined, the prevalence of late testing was 43.2%. Multivariate logistic regression results (n = 275) revealed five significant correlates of late testing: “I preferred not to know I had HIV” (adjusted odds ratio [AOR] = 2.78, 1.46–5.31); clinic (AOR = 1.90, 1.06–3.41); exposure to peers engaging in high-risk sexual behavior (AOR = 1.14, 1.02–1.27); stigma regarding HIV-infected individuals (AOR = 0.65, 0.47–0.92); and stigma regarding HIV testing (AOR = 0.66, 0.45–0.97). These findings may inform the design of interventions to increase timely HIV testing and help reduce HIV transmission in the community at large. PMID:20438374

  8. Public readiness for HIV self-testing in Kenya

    PubMed Central

    Heard, Anna C.; Brown, Annette N.

    2016-01-01

    ABSTRACT High interest and a growing body of evidence suggest that HIV self-testing could help fill the HIV testing gap for populations who have been hesitant to access testing services through current mechanisms. Evidence from five of six studies funded by 3ie answers questions posed by the Kenyan government to understand the readiness of Kenyans for HIV self-testing. The findings suggest that Kenyans are generally ready for HIV self-testing. Most people would not only like to obtain self-test kits through public health facilities but also expect to be able to obtain them from pharmacies – easy access being a key factor for a distribution outlet. Respondents across the studies seem to understand the importance of counseling and confirmatory testing, although the decision to access services after an HIV self-test will certainly be influenced by the results of the test. Respondents do have some concerns about potential harms and abuses from HIV self-tests. These concerns are focused on what they expect others would do, rather than reflections of what they say they would do themselves. Additionally, most people believe that such concerns were mostly unwarranted and/or could be addressed. PMID:27256543

  9. Rapid HIV testing for developing countries: the challenge of false-negative tests

    NASA Astrophysics Data System (ADS)

    Yogev, Ram

    2012-06-01

    It is a common practice in resource-constrained countries to accept two positive rapid HIV antibody test results as diagnostic for HIV infection. Because these tests are inexpensive and results are obtained quickly, they are recommended by the WHO to "scale-up" HIV testing to increase the number of people tested. The negative predictive value of rapid HIV tests is so high that negative results are considered conclusive despite the fact that false-negative results can occur in several situations. While the specificity and sensitivity of rapid HIV tests in resource-rich countries is acceptable, there are only limited data about their performance in resource-constrained countries. The challenges of rapid HIV testing in these situations will be discussed.

  10. Evaluation of the enzyme-linked immunosorbent assay (ELISA) and other serological tests for the diagnosis of toxoplasmosis

    PubMed Central

    Carlier, Y.; Bout, D.; Dessaint, J. P.; Capron, A.; Van Knapen, F.; Ruitenberg, E. J.; Bergquist, R.; Huldt, G.

    1980-01-01

    The enzyme-linked immunosorbent assay (ELISA) was evaluated in human toxoplasmosis in three laboratories using their own procedures. The same batch of serum samples was investigated in the three laboratories. ELISA results were compared by statistical analysis both with one another and with those of the dye test (DT), immunofluorescence (IF), complement fixation test (CFT), and indirect haemagglutination (IHA). Highly significant correlations were obtained between the three laboratories with ELISA using two different antigens and enzyme conjugates. The correlations between ELISA and the other serological tests showed the following sequence: CFT>IF>IHA>DT. Highly significant correlations were obtained between ELISA using anti-γ-chain and anti-total immunoglobulin conjugates. The agreement in discrimination between sera with low and high antibody levels was good for all the different ELISA techniques but discrimination between positive and negative sera depended rather on the ELISA procedure used. PMID:6991147

  11. Harnessing the heightened public awareness of celebrity HIV disclosures: "Magic" and "Cookie" Johnson and HIV testing.

    PubMed

    Tesoriero, J M; Sorin, M D; Burrows, K A; LaChance-McCullough, M L

    1995-06-01

    This article investigates the impact NBA basketball star Earvin ("Magic") Johnson's HIV disclosure had on changes in demand for HIV counseling and testing services in New York State's 61 Anonymous HIV Counseling and Testing sites. Interrupted time-series analyses were conducted on weekly data from over 34,000 clients seeking anonymous HIV counseling and testing services from January 1991 to June 1992, to determine whether demand for these services changed as a result of the disclosure. Results indicated that immediately following the HIV disclosure, there was a substantial increase in service demand, which transcended all sex, race, age, and most HIV risk-related boundaries. Seven months later, demand had not returned to pre-disclosure levels. The strong impact on females, coupled with additional data analyses in obstetrical settings, suggests that previous research has been too narrow in focus, and that the effect of Johnson's HIV disclosure has been enhanced, in part, by the publicity surrounding his wife and baby. The importance of harnessing the heightened public awareness of celebrity HIV disclosures is discussed.

  12. Serological cross-reaction between Legionella pneumophila and campylobacter in the indirect fluorescent antibody test.

    PubMed Central

    Boswell, T. C.; Kudesia, G.

    1992-01-01

    Sera from 50 patients with culture-proven campylobacter gastroenteritis were examined for the presence of antibodies to Legionella pneumophila. Ten patients (20%) had a positive titre (> or = 16) as measured by indirect immunofluorescence. Antibodies were detected in only 1 of 36 acute sera but in 10 of 14 (71%) sera obtained more than 10 days after the onset of symptoms. All positive sera contained specific IgM antibodies but specific IgG or IgA could not be detected in any sample. No legionella antibodies could be detected in sera from 42 similar patients with salmonella gastroenteritis. These results were shown to be due to serological cross-reaction between L. pneumophila and campylobacter. PMID:1397117

  13. Value of serological tests in the diagnosis of viral acute respiratory infections in adults.

    PubMed

    Căruntu, F; Dogaru, D; Stefan, D; Căruntu, V; Angelescu, C; Streinu-Cercel, A; Colţan, G; Petrescu, A L; Tarţă, D; Bârnaure, F

    1986-01-01

    The dynamics of the antibody response to influenza viruses A (H1N1), A (H3N2) and B, to parainfluenza viruses 1, 2, 3, to adenoviruses and respiratory syncytial virus was studied in paired serum samples collected from 110 patients hospitalized with acute respiratory infections (ARI) and in 40 patients suffering from other diseases. Rises in serum antibody titers to 1--5 of the above mentioned antigens were detected in many of the patients of both groups. The fact is most likely due to the presence of some epidemiologically and clinically uncharacteristic viral ARI (influenza included); simultaneous or successive infections with influenza virus and different other viruses were very frequent. A greater efficiency of the etiological diagnosis of viral ARI can be achieved only by the association of epidemiological and clinical criteria with serological data, the visualization of viral antigens and virus isolation.

  14. Early and complete detection of HIV exposure.

    PubMed

    Jehuda-Cohen, T

    1993-10-01

    Currently, HIV diagnosis relies on serology. Yet in groups at high risk for HIV serology is not sufficient because of the window period between infection and seroconversion. There is a growing body of reports on HIV-infected yet seronegative individuals. Some tests have been developed to identify exposure to HIV by its effect on the cells of the immune system that would differentiate following exposure to the foreign antigens. Detection, in vitro, of HIV-specific B and T cells in seronegative, at risk individuals has been reported. In only some of these individuals was an HIV infection confirmed by other methods. These new assays to detect HIV immunity enable us to identify two new groups among seronegative, at risk individuals; namely those with immunity to HIV and a detectable HIV infection (silent carriers), and those with immunity and no proof of infection. Both groups have been exposed to HIV yet are not being detected by serology. Both might hold information on other forms of HIV immunity, possibly a protective one. Thus there could be an important role for other immunological assays in early detection of HIV exposure.

  15. HIV self-testing practices among Health Care Workers: feasibility and options for accelerating HIV testing services in Ethiopia

    PubMed Central

    Kebede, Bekana; Abate, Tatek; Mekonnen, Desalew

    2013-01-01

    Introduction HIV is still an enormous global burden and it is also causing loss of huge health care workers (HCWs) on the already limited human resource capacity in health care services in Sub-Saharan Africa. Variety of methods of accelerating HIV testing is required to increase the rate of HIV testing and expand treatment services. Therefore, this study was aimed to find out the prevalence, feasibility and options of HIV self-testing practices in Ethiopia. Methods A cross-sectional study design triangulated with qualitative method was conducted from February to May, 2012. The data was collected using a semi-structured pretested questionnaire and in-depth interview, at government and private health centers or clinics and hospitals. During the data collection all the available healthcare workers (HCWs) which encompass the internship students including: Medical, Health Officer, Nurses, Midwives and Laboratory students, and health professionals working in the selected health institutions were involved. Results A total of 307 HCWs were included in the analysis and we found that 288(94.4%) of them were ever tested for HIV, of which majority 203 (70.5%) were tested by themselves though 244(80%) of the HCWs had motivation or interest to be tested by themselves. Generally, of the ever tested only 85(29.5%) were tested by the help of health care providers/counselors other than self. Regarding the place where the HCWs had the test, majority 136 (69.4%) tested by themselves at the health facility and the rest were tested at their home, office, market and church. The main reason stated for self-testing was the need for confidentiality for the test result, which was mentioned by 205(82%). Moreover, 35(14.0%) claims lack of time to access the ordinary counseling and testing services. Conclusion This study depicts high rate of HIV self-testing practice among HCWs. This shows that HIV self-testing can be considered as one pillar to increase the HIV-testing services and a means for

  16. Accounting for False Positive HIV Tests: Is Visceral Leishmaniasis Responsible?

    PubMed Central

    Shanks, Leslie; Ritmeijer, Koert; Piriou, Erwan; Siddiqui, M. Ruby; Kliescikova, Jarmila; Pearce, Neil; Ariti, Cono; Muluneh, Libsework; Masiga, Johnson; Abebe, Almaz

    2015-01-01

    Background Co-infection with HIV and visceral leishmaniasis is an important consideration in treatment of either disease in endemic areas. Diagnosis of HIV in resource-limited settings relies on rapid diagnostic tests used together in an algorithm. A limitation of the HIV diagnostic algorithm is that it is vulnerable to falsely positive reactions due to cross reactivity. It has been postulated that visceral leishmaniasis (VL) infection can increase this risk of false positive HIV results. This cross sectional study compared the risk of false positive HIV results in VL patients with non-VL individuals. Methodology/Principal Findings Participants were recruited from 2 sites in Ethiopia. The Ethiopian algorithm of a tiebreaker using 3 rapid diagnostic tests (RDTs) was used to test for HIV. The gold standard test was the Western Blot, with indeterminate results resolved by PCR testing. Every RDT screen positive individual was included for testing with the gold standard along with 10% of all negatives. The final analysis included 89 VL and 405 non-VL patients. HIV prevalence was found to be 12.8% (47/ 367) in the VL group compared to 7.9% (200/2526) in the non-VL group. The RDT algorithm in the VL group yielded 47 positives, 4 false positives, and 38 negatives. The same algorithm for those without VL had 200 positives, 14 false positives, and 191 negatives. Specificity and positive predictive value for the group with VL was less than the non-VL group; however, the difference was not found to be significant (p = 0.52 and p = 0.76, respectively). Conclusion The test algorithm yielded a high number of HIV false positive results. However, we were unable to demonstrate a significant difference between groups with and without VL disease. This suggests that the presence of endemic visceral leishmaniasis alone cannot account for the high number of false positive HIV results in our study. PMID:26161864

  17. Costs of Expanded Rapid HIV Testing in Four Emergency Departments

    PubMed Central

    Eggman, Ashley A.; Leff, Jared A.; Braunlin, Megan; Felsen, Uriel R.; Fitzpatrick, Lisa; Telzak, Edward E.; El-Sadr, Wafaa; Branson, Bernard M.

    2016-01-01

    Objective The HIV Prevention Trials Network (HPTN) 065 trial sought to expand HIV screening of emergency department (ED) patients in Bronx, New York, and Washington, D.C. This study assessed the testing costs associated with different expansion processes and compared them with costs of a hypothetical optimized process. Methods Micro-costing studies were conducted in two participating EDs in each city that switched from point-of-care (POC) to rapid-result laboratory testing. In three EDs, laboratory HIV testing was only conducted for patients having blood drawn for clinical reasons; in the other ED, all HIV testing was conducted with laboratory testing. Costs were estimated through direct observation and interviews to document process flows, time estimates, and labor and materials costs. A hypothetical optimized process flow used minimum time estimates for each process step. National wage and fringe rates and local reagent costs were used to determine the average cost (excluding overhead) per completed nonreactive and reactive test in 2013 U.S. dollars. Results Laboratory HIV testing costs in the EDs ranged from $17.00 to $23.83 per completed nonreactive test, and POC testing costs ranged from $17.64 to $37.60; cost per completed reactive test ranged from $89.29 to $123.17. Costs of hypothetical optimized HIV testing with automated process steps were approximately 45% lower for nonreactive tests and 20% lower for reactive tests. The cost per ED visit to conduct expanded HIV testing in each hospital ranged from $1.21 to $3.96. Conclusion An optimized process could achieve additional cost savings but would require an investment in electronic system interfaces to further automate testing processes. PMID:26862232

  18. Costs of Expanded Rapid HIV Testing in Four Emergency Departments.

    PubMed

    Schackman, Bruce R; Eggman, Ashley A; Leff, Jared A; Braunlin, Megan; Felsen, Uriel R; Fitzpatrick, Lisa; Telzak, Edward E; El-Sadr, Wafaa; Branson, Bernard M

    2016-01-01

    The HIV Prevention Trials Network (HPTN) 065 trial sought to expand HIV screening of emergency department (ED) patients in Bronx, New York, and Washington, D.C. This study assessed the testing costs associated with different expansion processes and compared them with costs of a hypothetical optimized process. Micro-costing studies were conducted in two participating EDs in each city that switched from point-of-care (POC) to rapid-result laboratory testing. In three EDs, laboratory HIV testing was only conducted for patients having blood drawn for clinical reasons; in the other ED, all HIV testing was conducted with laboratory testing. Costs were estimated through direct observation and interviews to document process flows, time estimates, and labor and materials costs. A hypothetical optimized process flow used minimum time estimates for each process step. National wage and fringe rates and local reagent costs were used to determine the average cost (excluding overhead) per completed nonreactive and reactive test in 2013 U.S. dollars. Laboratory HIV testing costs in the EDs ranged from $17.00 to $23.83 per completed nonreactive test, and POC testing costs ranged from $17.64 to $37.60; cost per completed reactive test ranged from $89.29 to $123.17. Costs of hypothetical optimized HIV testing with automated process steps were approximately 45% lower for nonreactive tests and 20% lower for reactive tests. The cost per ED visit to conduct expanded HIV testing in each hospital ranged from $1.21 to $3.96. An optimized process could achieve additional cost savings but would require an investment in electronic system interfaces to further automate testing processes.

  19. Can we do more with HIV testing?

    PubMed

    Nathan, Mayura

    2017-03-23

    In 2015, an estimated 0.8% of adults aged 15 - 49 years world-wide are living with HIV infection, though the rates have been variable between countries and regions (www.who.int/gho/hiv/en/). The rates in Europe has been estimated to be around 0.4%. The diagnosed HIV prevalence rate in London in 2015 was 5.8 per 1000 residents aged 15 - 59 years (https://www.gov.uk/government/uploads/system/uploads/attachment data/ file/594779 /). But the rates were much higher (~27) in Black African populations than in the White population (~5). This article is protected by copyright. All rights reserved.

  20. Development and psychometric testing of a barriers to HIV testing scale among individuals with HIV infection in Sweden; The Barriers to HIV testing scale-Karolinska version.

    PubMed

    Wiklander, Maria; Brännström, Johanna; Svedhem, Veronica; Eriksson, Lars E

    2015-11-19

    Barriers to HIV testing experienced by individuals at risk for HIV can result in treatment delay and further transmission of the disease. Instruments to systematically measure barriers are scarce, but could contribute to improved strategies for HIV testing. Aims of this study were to develop and test a barriers to HIV testing scale in a Swedish context. An 18-item scale was developed, based on an existing scale with addition of six new items related to fear of the disease or negative consequences of being diagnosed as HIV-infected. Items were phrased as statements about potential barriers with a three-point response format representing not important, somewhat important, and very important. The scale was evaluated regarding missing values, floor and ceiling effects, exploratory factor analysis, and internal consistencies. The questionnaire was completed by 292 adults recently diagnosed with HIV infection, of whom 7 were excluded (≥9 items missing) and 285 were included (≥12 items completed) in the analyses. The participants were 18-70 years old (mean 40.5, SD 11.5), 39 % were females and 77 % born outside Sweden. Routes of transmission were heterosexual transmission 63 %, male to male sex 20 %, intravenous drug use 5 %, blood product/transfusion 2 %, and unknown 9 %. All scale items had <3 % missing values. The data was feasible for factor analysis (KMO = 0.92) and a four-factor solution was chosen, based on level of explained common variance (58.64 %) and interpretability of factor structure. The factors were interpreted as; personal consequences, structural barriers, social and economic security, and confidentiality. Ratings on the minimum level (suggested barrier not important) were common, resulting in substantial floor effects on the scales. The scales were internally consistent (Cronbach's α 0.78-0.91). This study gives preliminary evidence of the scale being feasible, reliable and valid to identify different types of barriers to HIV testing.

  1. Importance of an Early HIV Antibody Differentiation Immunoassay for Detection of Dual Infection with HIV-1 and HIV-2.

    PubMed

    Zbinden, Andrea; Dürig, Roland; Shah, Cyril; Böni, Jürg; Schüpbach, Jörg

    2016-01-01

    HIV-2 is primarily endemic in West Africa and India, however, in time of global migration, a possible HIV-2 infection or co-infection with HIV-1 should be recognized right at the time of HIV diagnosis, in order to enable optimized antiretroviral treatment. Laboratory HIV testing consists of a combined HIV1/2/O antibody + antigen screening test and subsequent confirmation and type differentiation by a serological test formatted as a multi-line or multi-spot assay. CDC has proposed a revised alternative HIV diagnostic strategy which, in case of a reactive result in a combined HIV1/2/O antibody + antigen screening test, comprises an HIV-1 nucleic acid test (NAT) for HIV confirmation instead of an antibody differentiation immunoassay (ADI). Only a negative NAT must be further investigated by an ADI, thus saving expenses for ADI in most instances. We have investigated this alternative strategy with respect to its recognition of dual HIV-1 and HIV-2 infection. Anonymized data of HIV notifications of patients newly diagnosed with HIV in Switzerland between 2007 and 2014 were analysed retrospectively. In a total of 4'679 notifications, we found 35 HIV-2 infections, 9 (25.7%) of which were dually infected with HIV-1. In 7 of the 9 dual HIV-1 and HIV-2 infections, HIV-1 RNA testing at the time of HIV diagnosis was positive with concentrations from 102 to 94'300 copies/mL plasma. HIV-1 RNA data were not available for the other two cases. The alternative CDC strategy would have missed the concomitant HIV-2 infection in at least 7, but probably even more, of the 9 dually infected patients, as the detectable HIV-1 RNA would have precluded a supplemental ADI. Early ADI is mandatory for diagnosis of dual HIV-1/HIV-2 infection and guidance of appropriate therapy.

  2. HIV testing and counseling among adolescents attending family planning clinics.

    PubMed

    Smith, P B; Buzi, R S; Weinman, M L

    2005-05-01

    This study examined whether an assessment tool combining HIV-related risk behaviors and symptoms would increase HIV testing and return for post-test counseling among 466 adolescents attending family planning clinics. The results indicted that high-risk behaviors were common among these adolescents. The majority (78.3%) identified themselves as not using condoms consistently, almost a quarter (24.7%) reported a history of STDs and 129 (27.7%) reported they had pierced their bodies. A total of 214 (45.9%) received HIV testing. Two (0.4%) adolescents, one male and one female, tested positive for HIV. Of the 214 adolescents who underwent testing, 183 (85.5%) returned to the clinic for post-test counseling. The results of this study indicated that adolescents who reported risk behaviors and symptoms were not more likely than those who reported no risk behaviors and symptoms to request testing and return for post-test counseling. In light of these results, the authors review the protocols associated with testing and post-test counseling and propose solutions that can potentially improve these processes. The authors recommend integrating a risk assessment tool with HIV testing in family planning clinics as testing and return for post-test counseling rates were high.

  3. An Adaptive Approach to Locating Mobile HIV Testing Services.

    PubMed

    Gonsalves, Gregg S; Crawford, Forrest W; Cleary, Paul D; Kaplan, Edward H; Paltiel, A David

    2017-07-01

    Public health agencies suggest targeting "hotspots" to identify individuals with undetected HIV infection. However, definitions of hotspots vary. Little is known about how best to target mobile HIV testing resources. We conducted a computer-based tournament to compare the yield of 4 algorithms for mobile HIV testing. Over 180 rounds of play, the algorithms selected 1 of 3 hypothetical zones, each with unknown prevalence of undiagnosed HIV, in which to conduct a fixed number of HIV tests. The algorithms were: 1) Thompson Sampling, an adaptive Bayesian search strategy; 2) Explore-then-Exploit, a strategy that initially draws comparable samples from all zones and then devotes all remaining rounds of play to HIV testing in whichever zone produced the highest observed yield; 3) Retrospection, a strategy using only base prevalence information; and; 4) Clairvoyance, a benchmarking strategy that employs perfect information about HIV prevalence in each zone. Over 250 tournament runs, Thompson Sampling outperformed Explore-then-Exploit 66% of the time, identifying 15% more cases. Thompson Sampling's superiority persisted in a variety of circumstances examined in the sensitivity analysis. Case detection rates using Thompson Sampling were, on average, within 90% of the benchmark established by Clairvoyance. Retrospection was consistently the poorest performer. We did not consider either selection bias (i.e., the correlation between infection status and the decision to obtain an HIV test) or the costs of relocation to another zone from one round of play to the next. Adaptive methods like Thompson Sampling for mobile HIV testing are practical and effective, and may have advantages over other commonly used strategies.

  4. HIV Testing in the United States

    MedlinePlus

    ... Return to text U.S. Federal Bureau of Prisons, Legal Resource Guide to the Federal Bureau of Prisons ; November 2008. ← Return to text U.S. Department of Justice, Bureau of Justice Statistics, HIV in Prisons, 2007- ...

  5. Many with Mental Illness Miss Out on HIV Tests

    MedlinePlus

    ... medlineplus.gov/news/fullstory_163139.html Many With Mental Illness Miss Out on HIV Tests Rates of infection ... Jan. 19, 2017 (HealthDay News) -- People with severe mental illness are only slightly more likely to be screened ...

  6. Governor vetoes bill that would test sex offenders for HIV.

    PubMed

    1998-06-26

    The Governor of Colorado vetoed a bill that gave prosecutors ammunition to bring felony charges against HIV-infected defendants arrested for sex offenses. The bill would have required HIV testing prior to trial for persons accused of crimes involving sexual penetration. Receipt of a positive test could force public health agencies to disclose prior test results for the same person. The veto was made on the assumption that greater harm would be done in the fight against HIV disease by compromising test confidentiality than would be gained in raising prosecutorial power. Additionally, falsely accused defendants, despite a subsequent acquittal, would still have had the confidentiality of their HIV status automatically breached during the prosecutorial process under the vetoed bill.

  7. Supporting the Integration of HIV Testing Into Primary Care Settings

    PubMed Central

    Bradley-Springer, Lucy; Kang Dufour, Mi-Suk; Koester, Kimberly A.; Beane, Stephanie; Warren, Nancy; Beal, Jeffrey; Frank, Linda Rose

    2012-01-01

    Objectives. We examined the efforts of the US network of AIDS Education and Training Centers (AETCs) to increase HIV testing capacity across a variety of clinical settings. Methods. We used quantitative process data from 8 regional AETCs for July 1, 2008, to June 30, 2009, and qualitative program descriptions to demonstrate how AETC education helped providers integrate HIV testing into routine clinical care with the goals of early diagnosis and treatment. Results. Compared with other AETC training, HIV testing training was longer and used a broader variety of strategies to educate more providers per training. During education, providers were able to understand their primary care responsibility to address public health concerns through HIV testing. Conclusions. AETC efforts illustrate how integration of the principles of primary care and public health can be promoted through professional training. PMID:22515867

  8. Collaborative study for the validation of serological methods for potency testing of diphtheria toxoid vaccines-part 1.

    PubMed

    Winsnes, R; Sesardic, D; Daas, A; Behr-Gross, M-E

    2004-01-01

    A collaborative study on the evaluation of an alternative functional assay, the Vero cell method, to the Ph. Eur. in vivo challenge procedures for potency determination of diphtheria toxoid in 6 different combined vaccines was initiated in January 2001. The study was an extension of a previous study for the validation of serological methods for potency testing of tetanus toxoid vaccines for human use. To allow interim evaluation of test results and to monitor study progress, the project was divided into three consecutive phases. The results of Phase I and II studies are presented in this report. Pre-validation (Phase I) study, performed in two laboratories, indicated that comparable diphtheria potency estimates were obtained in the Ph. Eur. direct intradermal challenge assay in guinea pigs, in Vero cell assay and in indirect ELISA for five vaccines of different potencies (range of estimates: ca. 20-200 IU/ml). The correlation coefficients between the challenge assay and the Vero cell assay corresponded to those between the challenge assay and ELISA, confirming that the antibodies play an important role in protection and that predominantly protective/neutralising antibodies are present in guinea pigs, at the time point investigated. It was observed, for Vero cell assays, that about 16-35 (9-28 in Phase II study) fold lower titre of individual serum samples were obtained when using equine, rather than guinea pig reference serum. The study also provided preliminary information that sera from the same guinea pigs may be used for potency determination of both diphtheria and tetanus toxoid components of vaccines. In Phase II, another five laboratories analysed a subset of the vaccines included in Phase I study plus an additional vaccine. Four laboratories performed the lethal challenge assay and one laboratory carried out the intradermal challenge assay. All laboratories also performed the Vero cell assay and both ELISA for diphtheria antitoxin and ELISA for tetanus

  9. Sexual behaviors and HIV/syphilis testing among transgender individuals in China: implications for expanding HIV testing services.

    PubMed

    Best, John; Tang, Weiming; Zhang, Ye; Han, Larry; Liu, Fengying; Huang, Shujie; Yang, Bin; Wei, Chongyi; Tucker, Joseph D

    2015-05-01

    HIV and syphilis are disproportionately common among transgender individuals globally, yet few studies have investigated transgender HIV/syphilis risk and testing in low- and middle-income nations. We conducted an online survey of men who have sex with men (MSM) and transgender individuals to examine sexual behaviors and HIV/syphilis testing in China. We recruited MSM and transgender individuals from 2 major Chinese lesbian, gay, bisexual, and transgender Web platforms. χ Test and logistic regression were used to compare risk behaviors, HIV and syphilis testing history, and prevalence between transgender individuals and other MSM. Among the 1320 participants, 52 (3.9%) self-identified as transgender. Demographics, including education, employment, and marital status, were similar between both groups, whereas transgender individuals were older. Condomless anal intercourse rate was comparable between the groups. Transgender individuals were less likely to report ever testing for HIV (34.6% vs. 62.0%) and syphilis (15.7% vs. 31.2%) with adjusted odds ratios of 0.36 (95% confidence interval, 0.20-0.65) and 0.42 (95% confidence interval, 0.20-0.91), respectively. We found a trend toward a higher HIV prevalence among transgender individuals (11.1% vs. 5.7%, P = 0.12). Transgender individuals have suboptimal HIV and syphilis testing rates in China. Given the substantial risk behaviors and burden of HIV/STI in the general Chinese MSM population and a lack of knowledge about transgender individuals, enhanced HIV/syphilis testing programs for transgender individuals in China are needed.

  10. HIV Risk Behaviors Among Latina Women Tested for HIV in Florida by Country of Birth, 2012.

    PubMed

    Taveras, Janelle; Trepka, Mary Jo; Khan, Hafiz; Madhivanan, Purnima; Gollub, Erica L; Devieux, Jessy

    2016-10-01

    Latina women in the United States (US) are disproportionately affected by human immunodeficiency virus (HIV) infection. Data are limited on the risk differences in HIV among Latinas by country of birth. This paper describes the risk behaviors among Latina women tested for HIV at public sites in Florida. Multivariate logistic regression was used to assess the demographic characteristics associated with the report of specific risk behaviors. Results indicate that foreign-born Latina women were 54 % less likely to report partner risk [95 % confidence interval (CI) 0.40, 0.54] than US-born Latina women. Reported risk behaviors varied by race/ethnicity, US-born versus foreign-born status, and by Latina country of origin. Knowledge of these differences can aid in targeting HIV prevention messaging, program decision-making, and allocation of resources, corresponding to the central approach of High Impact Prevention and the National HIV/AIDS Strategy.

  11. Sexual Behaviors and HIV/Syphilis Testing Among Transgender Individuals in China: Implications for Expanding HIV Testing Services

    PubMed Central

    Best, John; Tang, Weiming; Zhang, Ye; Han, Larry; Liu, Fengying; Huang, Shujie; Yang, Bin; Wei, Chongyi; Tucker, Joseph D.

    2015-01-01

    Background HIV and syphilis are disproportionately common among transgender individuals globally, yet few studies have investigated transgender HIV/syphilis risk and testing in low and middle-income nations. We conducted an online survey of men who have sex with men (MSM) and transgender individuals to examine sexual behaviors, and HIV/syphilis testing in China. Methods We recruited MSM and transgender individuals from two-major Chinese lesbian, gay, bisexual, and transgender (LGBT) web platforms. Chi-square and logistic regression were used to compare risk behaviors, HIV and syphilis testing history, and prevalence between transgender individuals and other MSM. Results Among the 1320 participants, 52 (3·9%) self-identified as transgender. Demographics, including education, employment, and marital status were similar between both groups, while transgender individuals were older. Condomless anal intercourse rate was comparable between the groups. Transgender individuals were less likely to report ever testing for HIV (34·6% VS 62·0%) and syphilis (15·7% VS 31·2%) with adjusted ORs of 0·36 (95% CI 0·20–0·65) and 0·42 (95% CI 0·20–0·91), respectively. We found a trend towards higher HIV prevalence among transgender individuals (11·1% VS5·7%, P=0·12). Conclusion Transgender individuals have suboptimal HIV and syphilis testing rates in China. Given the substantial risk behaviors and burden of HIV/STI in the general Chinese MSM population and lack of knowledge about transgender individuals, enhanced HIV/syphilis testing programs for transgender individuals in China are needed. PMID:25868142

  12. Information Behavior and HIV Testing Intentions Among Young Men at Risk for HIV/AIDS

    PubMed Central

    Meadowbrooke, Chrysta C.; Veinot, Tiffany C.; Loveluck, Jimena; Hickok, Andrew; Bauermeister, José A.

    2014-01-01

    Health research shows that knowing about health risks may not translate into behavior change. However, such research typically operationalizes health information acquisition with knowledge tests. Information scientists who investigate socially embedded information behaviors could help improve understanding of potential associations between information behavior—as opposed to knowledge—and health behavior formation, thus providing new opportunities to investigate the effects of health information. We examine the associations between information behavior and HIV testing intentions among young men who have sex with men (YMSM), a group with high rates of unrecognized HIV infection. We used the theory of planned behavior (TPB) to predict intentions to seek HIV testing in an online sample of 163 YMSM. Multiple regression and recursive path analysis were used to test two models: (a) the basic TPB model and (b) an adapted model that added the direct effects of three information behaviors (information exposure, use of information to make HIV-testing decisions, prior experience obtaining an HIV test) plus self-rated HIV knowledge. As hypothesized, our adapted model improved predictions, explaining more than twice as much variance as the original TPB model. The results suggest that information behaviors may be more important predictors of health behavior intentions than previously acknowledged. PMID:25346934

  13. Information Behavior and HIV Testing Intentions Among Young Men at Risk for HIV/AIDS.

    PubMed

    Meadowbrooke, Chrysta C; Veinot, Tiffany C; Loveluck, Jimena; Hickok, Andrew; Bauermeister, José A

    2014-03-01

    Health research shows that knowing about health risks may not translate into behavior change. However, such research typically operationalizes health information acquisition with knowledge tests. Information scientists who investigate socially embedded information behaviors could help improve understanding of potential associations between information behavior-as opposed to knowledge-and health behavior formation, thus providing new opportunities to investigate the effects of health information. We examine the associations between information behavior and HIV testing intentions among young men who have sex with men (YMSM), a group with high rates of unrecognized HIV infection. We used the theory of planned behavior (TPB) to predict intentions to seek HIV testing in an online sample of 163 YMSM. Multiple regression and recursive path analysis were used to test two models: (a) the basic TPB model and (b) an adapted model that added the direct effects of three information behaviors (information exposure, use of information to make HIV-testing decisions, prior experience obtaining an HIV test) plus self-rated HIV knowledge. As hypothesized, our adapted model improved predictions, explaining more than twice as much variance as the original TPB model. The results suggest that information behaviors may be more important predictors of health behavior intentions than previously acknowledged.

  14. Experience of sexual violence among women in HIV discordant unions after voluntary HIV counselling and testing

    PubMed Central

    Emusu, Donath; Ivankova, Nataliya; Jolly, Pauline; Kirby, Russell; Foushee, Herman; Wabwire-Mangen, Fred; Katongole, Drake; Ehiri, John

    2009-01-01

    HIV-serodiscordant relationships are those in which one partner is infected with HIV while the other is not. We investigated experiences of sexual violence among women in HIV discordant unions attending HIV post-test club services in Uganda. A volunteer sample of 26 women from three AIDS Information Centres in Uganda who reported having experienced sexual violence in a larger epidemiological study were interviewed, using the qualitative critical incident technique. Data were analysed using TEXTPACK, a software application for computer-assisted content analysis. Incidents of sexual violence narrated by the women included use of physical force and verbal threats. Overall, four themes that characterise the women’s experience of sexual violence emerged from the analysis: knowledge of HIV test results, prevalence of sexual violence, vulnerability and proprietary views and reactions to sexual violence. Alcohol abuse by the male partners was an important factor in the experience of sexual violence among the women. Their experiences evoked different reactions and feelings, including concern over the need to have children, fear of infection, desire to separate from their spouses/partners, helplessness, anger and suicidal tendencies. HIV counselling and testing centres should be supported with the capacity to address issues related to sexual violence for couples who are HIV discordant. PMID:20024712

  15. Failure to Identify HIV-Infected Individuals in a Clinical Trial Using a Single HIV Rapid Test for Screening

    PubMed Central

    Piwowar-Manning, Estelle; Fogel, Jessica M.; Laeyendecker, Oliver; Wolf, Shauna; Cummings, Vanessa; Marzinke, Mark A.; Clarke, William; Breaud, Autumn; Wendel, Sarah; Wang, Lei; Swanson, Priscilla; Hackett, John; Mannheimer, Sharon; del Rio, Carlos; Kuo, Irene; Harawa, Nina T.; Koblin, Beryl A.; Moore, Richard; Blankson, Joel N.; Eshleman, Susan H.

    2014-01-01

    Background In the HIV Prevention Trials Network (HPTN) 061 study, 8 (2.3%) of 348 HIV-infected participants identified as HIV uninfected at study enrollment using a single HIV rapid test for screening were found to be HIV infected after additional testing. Objectives To evaluate the performance of different HIV assays for detection of HIV infection in HPTN 061 participants with missed infection and individuals with viral suppression. Methods Plasma samples from 8 HPTN 061 participants, 17 elite controllers, and 101 individuals on antiretroviral treatment (ART) were tested for HIV with 3 rapid tests, 2 laboratory-based immunoassays, and a Western blot assay. The HPTN 061 samples were also tested with 2 HIV RNA assays and an antiretroviral drug assay. Results Of the 8 HPTN 061 participants with missed infection, 1 was an elite controller, 1 was taking ART, 2 were missed because of testing or clerical errors, 1 had recent HIV infection (identified using a multi-assay algorithm), and 3 had acute HIV infection. Two (1.7%) of 118 individuals with viral suppression (both taking ART) had at least 1 false-negative test. Conclusions In clinical trials, HIV infections can be missed for a variety of reasons. Using more than one assay to screen for HIV infection may reduce the number of missed infections. PMID:24710920

  16. Failure to identify HIV-infected individuals in a clinical trial using a single HIV rapid test for screening.

    PubMed

    Piwowar-Manning, Estelle; Fogel, Jessica M; Laeyendecker, Oliver; Wolf, Shauna; Cummings, Vanessa; Marzinke, Mark A; Clarke, William; Breaud, Autumn; Wendel, Sarah; Wang, Lei; Swanson, Priscilla; Hackett, John; Mannheimer, Sharon; Del Rio, Carlos; Kuo, Irene; Harawa, Nina T; Koblin, Beryl A; Moore, Richard; Blankson, Joel N; Eshleman, Susan H

    2014-01-01

    In the HIV Prevention Trials Network (HPTN) 061 study, 8 (2.3%) of 348 HIV-infected participants identified as HIV uninfected at study enrollment using a single HIV rapid test for screening were found to be HIV infected after additional testing. To evaluate the performance of different HIV assays for detection of HIV infection in HPTN 061 participants with missed infection and individuals with viral suppression. Plasma samples from 8 HPTN 061 participants, 17 elite controllers, and 101 individuals on antiretroviral treatment (ART) were tested for HIV with 3 rapid tests, 2 laboratory-based immunoassays, and a Western blot assay. The HPTN 061 samples were also tested with 2 HIV RNA assays and an antiretroviral drug assay. Of the 8 HPTN 061 participants with missed infection, 1 was an elite controller, 1 was taking ART, 2 were missed because of testing or clerical errors, 1 had recent HIV infection (identified using a multi-assay algorithm), and 3 had acute HIV infection. Two (1.7%) of 118 individuals with viral suppression (both taking ART) had at least 1 false-negative test. In clinical trials, HIV infections can be missed for a variety of reasons. Using more than one assay to screen for HIV infection may reduce the number of missed infections.

  17. Evaluation of a rapid serological test for the determination of Mycobacterium bovis infection in badgers (Meles meles) found dead.

    PubMed

    Chambers, Mark A; Lyashchenko, Konstantin P; Greenwald, Rena; Esfandiari, Javan; James, Eurig; Barker, Leslie; Jones, Jeff; Watkins, Gavin; Rolfe, Simon

    2010-03-01

    Between October 2005 and May 2006, a total of 727 badgers found dead in Wales were reported, and 550 were delivered to the Regional Laboratories of the Veterinary Laboratories Agency (VLA). Of the 459 carcasses suitable for examination, 55 were deemed to be infected with Mycobacterium bovis on the basis of culture, spoligotyping, and variable-number tandem repeat typing. Acid-fast bacteria were observed histologically in a further six badgers, but these bacteria were not confirmed as M. bovis by culture. A rapid serological test (BrockTB Stat-Pak) performed on thoracic blood showed a sensitivity of 35% and a specificity of 99%. Presence of M. bovis infection was 45 times more likely to be confirmed postmortem by culture in BrockTB Stat-Pak-reactive animals than in seronegative ones. Using visible carcass lesions as a marker of bovine tuberculosis (bTB) infection had a similar sensitivity (38%) but was significantly less specific (84%) than serology. The overall accuracy of the antibody detection was 93% (346 correct results from 374 tests), whereas the accuracy of regarding visible lesions as a marker for bTB infection was 78% (354 correct from 453 carcasses examined). Culture remains the gold standard method for detecting M. bovis infection in badgers. However, where resources are limited and/or an instant result is preferred, the BrockTB Stat-Pak could be used in field surveillance efforts to identify animals which should be examined further by only submitting test-negative animals to more detailed postmortem examination and culture.

  18. Socio-economic inequity in HIV testing in Malawi

    PubMed Central

    Kim, Sung Wook; Skordis-Worrall, Jolene; Haghparast-Bidgoli, Hassan; Pulkki-Brännström, Anni-Maria

    2016-01-01

    Background Human immunodeficiency virus (HIV) is a significant contributor to Malawi's burden of disease. Despite a number of studies describing socio-economic differences in HIV prevalence, there is a paucity of evidence on socio-economic inequity in HIV testing in Malawi. Objective To assess horizontal inequity (HI) in HIV testing in Malawi. Design Data from the Demographic and Health Surveys (DHSs) 2004 and 2010 in Malawi are used for the analysis. The sample size for DHS 2004 was 14,571 (women =11,362 and men=3,209), and for DHS 2010 it was 29,830 (women=22,716 and men=7,114). The concentration index is used to quantify the amount of socio-economic-related inequality in HIV testing. The inequality is a primary method in this study. Corrected need, a further adjustment of the standard decomposition index, was calculated. Standard HI was compared with corrected need-adjusted inequity. Variables used to measure health need include symptoms of sexually transmitted infections. Non-need variables include wealth, education, literacy and marital status. Results Between 2004 and 2010, the proportion of the population ever tested for HIV increased from 15 to 75% among women and from 16 to 54% among men. The need for HIV testing among men was concentrated among the relatively wealthy in 2004, but the need was more equitably distributed in 2010. Standard HI was 0.152 in 2004 and 0.008 in 2010 among women, and 0.186 in 2004 and 0.04 in 2010 among men. Rural–urban inequity also fell in this period, but HIV testing remained pro-rich among rural men (HI 0.041). The main social contributors to inequity in HIV testing were wealth in 2004 and education in 2010. Conclusions Inequity in HIV testing in Malawi decreased between 2004 and 2010. This may be due to the increased support to HIV testing by global donors over this period. PMID:27790970

  19. Screening Yield of HIV Antigen/Antibody Combination and Pooled HIV RNA Testing for Acute HIV Infection in a High-Prevalence Population.

    PubMed

    Peters, Philip J; Westheimer, Emily; Cohen, Stephanie; Hightow-Weidman, Lisa B; Moss, Nicholas; Tsoi, Benjamin; Hall, Laura; Fann, Charles; Daskalakis, Demetre C; Beagle, Steve; Patel, Pragna; Radix, Asa; Foust, Evelyn; Kohn, Robert P; Marmorino, Jenni; Pandori, Mark; Fu, Jie; Samandari, Taraz; Gay, Cynthia L

    2016-02-16

    Although acute HIV infection contributes disproportionately to onward HIV transmission, HIV testing has not routinely included screening for acute HIV infection. To evaluate the performance of an HIV antigen/antibody (Ag/Ab) combination assay to detect acute HIV infection compared with pooled HIV RNA testing. Multisite, prospective, within-individual comparison study conducted between September 2011 and October 2013 in 7 sexually transmitted infection clinics and 5 community-based programs in New York, California, and North Carolina. Participants were 12 years or older and seeking HIV testing, without known HIV infection. All participants with a negative rapid HIV test result were screened for acute HIV infection with an HIV Ag/Ab combination assay (index test) and pooled human immunodeficiency virus 1 (HIV-1) RNA testing. HIV RNA testing was the reference standard, with positive reference standard result defined as detectable HIV-1 RNA on an individual RNA test. Number and proportion with acute HIV infections detected. Among 86,836 participants with complete test results (median age, 29 years; 75.0% men; 51.8% men who have sex with men), established HIV infection was diagnosed in 1158 participants (1.33%) and acute HIV infection was diagnosed in 168 participants (0.19%). Acute HIV infection was detected in 134 participants with HIV Ag/Ab combination testing (0.15% [95% CI, 0.13%-0.18%]; sensitivity, 79.8% [95% CI, 72.9%-85.6%]; specificity, 99.9% [95% CI, 99.9%-99.9%]; positive predictive value, 59.0% [95% CI, 52.3%-65.5%]) and in 164 participants with pooled HIV RNA testing (0.19% [95% CI, 0.16%-0.22%]; sensitivity, 97.6% [95% CI, 94.0%-99.4%]; specificity, 100% [95% CI, 100%-100%]; positive predictive value, 96.5% [95% CI, 92.5%-98.7%]; sensitivity comparison, P < .001). Overall HIV Ag/Ab combination testing detected 82% of acute HIV infections detectable by pooled HIV RNA testing. Compared with rapid HIV testing alone, HIV Ag/Ab combination testing

  20. Late HIV Testing in a Cohort of HIV-Infected Patients in Puerto Rico.

    PubMed

    Tossas-Milligan, Katherine Y; Hunter-Mellado, Robert F; Mayor, Angel M; Fernández-Santos, Diana M; Dworkin, Mark S

    2015-09-01

    Late HIV testing (LT), defined as receiving an AIDS diagnosis within a year of one's first positive HIV test, is associated with higher HIV transmission, lower HAART effectiveness, and worse outcomes. Latinos represent 36% of LT in the US, yet research concerning LT among HIV cases in Puerto Rico is scarce. Multivariable logistic regression analysis was used to identify factors associated with LT, and a Cochran‒Armitage test was used to determine LT trends in an HIV-infected cohort followed at a clinic in Puerto Rico specialized in the management and treatment of HIV. From 2000 to 2011, 47% of eligible patients were late testers, with lower median CD4 counts (54 vs. 420 cells/mm3) and higher median HIV viral load counts (253,680 vs. 23,700 copies/mL) than non-LT patients. LT prevalence decreased significantly, from 47% in 2000 to 37% in 2011. In a mutually adjusted logistic regression model, males, older age at enrollment and past history of IDU significantly increased LT odds, whereas having a history of amphetamine use decreased LT odds. When the data were stratified by mode of transmission, it became apparent that only the category men who have sex with men (MSM) saw a significant reduction in the proportion of LT, falling from 67% in 2000 to 33% in 2011. These results suggest a gap in early HIV detection in Puerto Rico, a gap that decreased only among MSM. An evaluation of the manner in which current HIV-testing guidelines are implemented on the island is needed.

  1. Late HIV Testing in a Cohort of HIV-Infected Patients in Puerto Rico.

    PubMed

    Tossas-Milligan, Katherine Y; Hunter-Mellado, Robert F; Mayor, Angel M; Fernández-Santos, Diana M; Dworkin, Mark S

    2016-05-24

    Late HIV testing (LT), defined as receiving an AIDS diagnosis within a year of one's first positive HIV test, is associated with higher HIV transmission, lower HAART effectiveness, and worse outcomes. Latinos represent 36% of LT in the US, yet research concerning LT among HIV cases in Puerto Rico is scarce. Multivariable logistic regression analysis was used to identify factors associated with LT, and a Cochran‒Armitage test was used to determine LT trends in an HIV-infected cohort followed at a clinic in Puerto Rico specialized in the management and treatment of HIV. From 2000 to 2011, 47% of eligible patients were late testers, with lower median CD4 counts (54 vs. 420 cells/mm3) and higher median HIV viral load counts (253,680 vs. 23,700 copies/mL) than non-LT patients. LT prevalence decreased significantly, from 47% in 2000 to 37% in 2011. In a mutually adjusted logistic regression model, males, older age at enrollment and past history of IDU significantly increased LT odds, whereas having a history of amphetamine use decreased LT odds. When the data were stratified by mode of transmission, it became apparent that only the category men who have sex with men (MSM) saw a significant reduction in the proportion of LT, falling from 67% in 2000 to 33% in 2011. These results suggest a gap in early HIV detection in Puerto Rico, a gap that decreased only among MSM. An evaluation of the manner in which current HIV-testing guidelines are implemented on the island is needed.

  2. Opt-out HIV testing in prison: informed and voluntary?

    PubMed

    Rosen, David L; Golin, Carol E; Grodensky, Catherine A; May, Jeanine; Bowling, J Michael; DeVellis, Robert F; White, Becky L; Wohl, David A

    2015-01-01

    HIV testing in prison settings has been identified as an important mechanism to detect cases among high-risk, underserved populations. Several public health organizations recommend that testing across health-care settings, including prisons, be delivered in an opt-out manner. However, implementation of opt-out testing within prisons may pose challenges in delivering testing that is informed and understood to be voluntary. In a large state prison system with a policy of voluntary opt-out HIV testing, we randomly sampled adult prisoners in each of seven intake prisons within two weeks after their opportunity to be HIV tested. We surveyed prisoners' perception of HIV testing as voluntary or mandatory and used multivariable statistical models to identify factors associated with their perception. We also linked survey responses to lab records to determine if prisoners' test status (tested or not) matched their desired and perceived test status. Thirty-eight percent (359/936) perceived testing as voluntary. The perception that testing was mandatory was positively associated with age less than 25 years (adjusted relative risk [aRR]: 1.45, 95% confidence interval [CI]: 1.24, 1.71) and preference that testing be mandatory (aRR: 1.81, 95% CI: 1.41, 2.31) but negatively associated with entry into one of the intake prisons (aRR: 0.41 95% CI: 0.27, 0.63). Eighty-nine percent of prisoners wanted to be tested, 85% were tested according to their wishes, and 82% correctly understood whether or not they were tested. Most prisoners wanted to be HIV tested and were aware that they had been tested, but less than 40% understood testing to be voluntary. Prisoners' understanding of the voluntary nature of testing varied by intake prison and by a few individual-level factors. Testing procedures should ensure that opt-out testing is informed and understood to be voluntary by prisoners and other vulnerable populations.

  3. Opt-out HIV testing in prison: Informed and voluntary?

    PubMed Central

    Rosen, David L.; Golin, Carol E.; Grodensky, Catherine A.; May, Jeannine; Bowling, J. Michael; DeVellis, Robert F.; White, Becky L.; Wohl, David A.

    2014-01-01

    HIV testing in prison settings has been identified as an important mechanism to detect cases among high-risk, underserved populations. Several public health organizations recommend that testing across healthcare settings, including prisons, be delivered in an opt-out manner. However, implementation of opt-out testing within prisons may pose challenges in delivering testing that is informed and understood to be voluntary. In a large state prison system with a policy of voluntary opt-out HIV testing, we randomly sampled adult prisoners in each of seven intake prisons within two weeks after their opportunity to be HIV tested. We surveyed prisoners’ perception of HIV testing as voluntary or mandatory and used multivariable statistical models to identify factors associated with their perception. We also linked survey responses to lab records to determine if prisoners’ test status (tested or not) matched their desired and perceived test status. Thirty eight percent (359/936) perceived testing as voluntary. The perception that testing was mandatory was positively associated with age less than 25 years (adjusted relative risk [aRR]: 1.45, 95% CI: 1.24, 1.71) and preference that testing be mandatory (aRR: 1.81, 95% CI: 1.41, 2.31), but negatively associated with entry into one of the intake prisons (aRR: 0.41 95% CI: 0.27, 0.63). Eighty-nine percent of prisoners wanted to be tested, 85% were tested according to their wishes, and 82% correctly understood whether or not they were tested. Most prisoners wanted to be HIV tested and were aware that they had been tested, but less than 40% understood testing to be voluntary. Prisoners’ understanding of the voluntary nature of testing varied by intake prison and by a few individual-level factors. Testing procedures should ensure that opt-out testing is informed and understood to be voluntary by prisoners and other vulnerable populations. PMID:25506799

  4. Reviewing independent access to HIV testing, counselling and treatment for adolescents in HIV-specific laws in sub-Saharan Africa: implications for the HIV response.

    PubMed

    Eba, Patrick M; Lim, HyeYoung

    2017-08-11

    AIDS is a leading cause of death among adolescents in sub-Saharan Africa. Yet, legal, policy and social barriers continue to restrict their access to HIV services. In recent years, access to independent HIV testing and treatment for adolescents has gained increased attention. The 2013 WHO Guidance on HIV testing and counselling and care for adolescents living with HIV (WHO Guidance) calls for reviewing legal and regulatory frameworks to facilitate adolescents' access to comprehensive HIV services. As of 31 March 2017, some 28 countries in sub-Saharan Africa have adopted HIV-specific legislation. But there is limited understanding of the provisions of these laws on access to HIV services for adolescents and their implication on efforts to scale up HIV prevention, testing, treatment and care among this population. A desk review of 28 HIV-specific laws in sub-Saharan Africa complemented with the review of HIV testing policies in four countries using human rights norms and key public health recommendations from the 2013 WHO Guidance. These recommendations call on countries to (i) lower the age of consent to HIV testing and counselling and allow mature adolescents who have not reached the age of consent to independently access HIV testing, (ii) ensure access to HIV counselling for adolescents, (iii) protect the confidentiality of adolescents living with HIV and (iv) facilitate access to HIV treatment for adolescents living with HIV. Most HIV-specific laws fail to take into account human rights principles and public health recommendations for facilitating adolescents' access to HIV services. None of the countries with HIV-specific laws has adopted all four recommendations for access to HIV services for adolescents. Discrepancies exist between HIV laws and national policy documents. Inadequate and conflicting provisions in HIV laws are likely to hinder access to HIV testing, counselling and treatment for adolescents. Efforts to end legal barriers to access to HIV services

  5. Reviewing independent access to HIV testing, counselling and treatment for adolescents in HIV-specific laws in sub-Saharan Africa: implications for the HIV response

    PubMed Central

    Eba, Patrick M.; Lim, HyeYoung

    2017-01-01

    Abstract Introduction: AIDS is a leading cause of death among adolescents in sub-Saharan Africa. Yet, legal, policy and social barriers continue to restrict their access to HIV services. In recent years, access to independent HIV testing and treatment for adolescents has gained increased attention. The 2013 WHO Guidance on HIV testing and counselling and care for adolescents living with HIV (WHO Guidance) calls for reviewing legal and regulatory frameworks to facilitate adolescents’ access to comprehensive HIV services. As of 31 March 2017, some 28 countries in sub-Saharan Africa have adopted HIV-specific legislation. But there is limited understanding of the provisions of these laws on access to HIV services for adolescents and their implication on efforts to scale up HIV prevention, testing, treatment and care among this population. Methods: A desk review of 28 HIV-specific laws in sub-Saharan Africa complemented with the review of HIV testing policies in four countries using human rights norms and key public health recommendations from the 2013 WHO Guidance. These recommendations call on countries to (i) lower the age of consent to HIV testing and counselling and allow mature adolescents who have not reached the age of consent to independently access HIV testing, (ii) ensure access to HIV counselling for adolescents, (iii) protect the confidentiality of adolescents living with HIV and (iv) facilitate access to HIV treatment for adolescents living with HIV. Results: Most HIV-specific laws fail to take into account human rights principles and public health recommendations for facilitating adolescents’ access to HIV services. None of the countries with HIV-specific laws has adopted all four recommendations for access to HIV services for adolescents. Discrepancies exist between HIV laws and national policy documents. Inadequate and conflicting provisions in HIV laws are likely to hinder access to HIV testing, counselling and treatment for adolescents

  6. Evaluation of the diagnostic value of serologic microagglutination testing and a polymerase chain reaction assay for diagnosis of acute leptospirosis in dogs in a referral center.

    PubMed

    Fraune, Claudia Kümmerle; Schweighauser, Ariane; Francey, Thierry

    2013-05-15

    To determine the diagnostic value of a serologic microagglutination test (MAT) and a PCR assay on urine and blood for the diagnosis of leptospirosis in dogs with acute kidney injury (AKI). Cross-sectional study. Animals-76 dogs with AKI in a referral hospital (2008 to 2009). Dogs' leptospirosis status was defined with a paired serologic MAT against a panel of 11 Leptospira serovars as leptospirosis-associated (n = 30) or nonleptospirosis-associated AKI (12). In 34 dogs, convalescent serologic testing was not possible, and leptospirosis status was classified as undetermined. The diagnostic value of the MAT single acute or convalescent blood sample was determined in dogs in which leptospirosis status could be classified. The diagnostic value of a commercially available genus-specific PCR assay was evaluated by use of 36 blood samples and 20 urine samples. Serologic acute testing of an acute blood sample had a specificity of 100% (95% CI, 76% to 100%), a sensitivity of 50% (33% to 67%), and an accuracy of 64% (49% to 77%). Serologic testing of a convalescent blood sample had a specificity of 92% (65% to 99%), a sensitivity of 100% (87% to 100%), and an accuracy of 98% (88% to 100%). Results of the Leptospira PCR assay were negative for all samples from dogs for which leptospirosis status could be classified. Serologic MAT results were highly accurate for diagnosis of leptospirosis in dogs, despite a low sensitivity for early diagnosis. In this referral setting of dogs pretreated with antimicrobials, testing of blood and urine samples with a commercially available genus-specific PCR assay did not improve early diagnosis.

  7. A comparison of the complement fixation, indirect fluorescent antibody, and microagglutination tests for the serological diagnosis of rickettsial diseases.

    PubMed

    Newhouse, V F; Shepard, C C; Redus, M D; Tzianabos, T; McDade, J E

    1979-03-01

    Three techniques for the serological diagnosis of Rocky Mountain spotted fever were compared by testing 417 sera from 178 patients who very probably did not have rickettsial infections and 88 sera from 41 patients who very probably had Rocky Mountain spotted fever (SF). The techniques were complement fixation (CF), indirect fluorescent antibody (IFA), and microagglutination (MA). To avoid possible degradation during unnecessary purification, the antigens were prepared by methods that were as simple as possible. In the CF tests of 417 sera from patients with nonrickettsial diseases there was only one titer of 8 and none at higher dilutions, whereas with the IFA and MA tests 4-8% of the sera reacted with SF antigens and 4-20% reacted with murine typhus (MT) antigens; the evidence indicated that these reactions were not caused by specific rickettsial antibody. With the SF sera, it could be seen that the IFA test was the most sensitive and the MA test was the least sensitive at each interval after infection. Moreover, the IFA results showed the least number of confusing cross-reactions with MT antigens and the MA test showed the most. The relative advantages of the three tests in serodiagnosis of rickettsial diseases are discussed.

  8. Shared snorkel leads to coerced HIV test, suit alleges.

    PubMed

    1998-08-21

    An African-American mother is suing an Illinois clinic and a community center, alleging that they pressured her into having her son tested for HIV and strep throat because he shared a snorkel with a white boy at a public swimming pool. The mother contends that the community center pressured her because the white boy's mother insisted on the tests and threatened to sue the community center. The American Civil Liberties Union of Illinois has accused the community center and the clinic that performed the tests of racially motivated discrimination and violations of the state HIV testing and confidentiality laws. Also named in the suit is the doctor who performed the tests.

  9. HIV testing among low-income African-American mothers.

    PubMed

    Battle, R S; Cummings, G L; Yamada, K A; Krasnovsky, F M

    1996-04-01

    HIV testing patterns were examined among low-income African Americans who were mothers of young school-age children. In-person interviews were conducted to determine whether African-American women had been tested for HIV; their sexual behaviors, including the number of sexual partners and condom use; and health care access and utilization. Forty-one percent of the women had been tested for HIV; 18 percent tested more than once. Levels of education, source of primary health care, and type of insurance were not associated with HIV testing. The total number of sexual partners for their current lifetime and within the past five years was significantly associated with their HIV testing status (chi 2 = 39.97; DF = 3; p < .01 and chi 2 = 66.68; DF = 3; p < .01 respectively). Women who have used condoms during their last intercourse (20%) were less likely to have been tested than women who did not use a condom (50%) (p < .01). Results suggest that low-income African-American women get tested for HIV. This suggests that these women understand the concept of risk and how certain behaviors may place them at risk. However, these women still confront conditions that place them at risk, such as having sex with multiple partners and/or partners with a history of incarceration, in addition to drug use. HIV testing may not serve as the most effective intervention for this sub-population of women. Educational and preventive measures should extend to women outside traditional high-risk populations by incorporating methods to promote protective behavioral changes which will empower women with self-esteem and confidence.

  10. The search for an appropriate, affordable HIV test for Africa.

    PubMed

    Tam, M

    1990-07-01

    In comparison with the commercially available ELISA test for HIV, new more appropriate tests for use in African locales are being supported by USAID, PATH, the International Development Research Center of Canada and the Rockefeller Foundation. ELISA tests are suited for high volume, high technology, automation, data management, accuracy, and cost about US$1 per test. In contrast, tests for African laboratories must be inexpensive, suitable for small numbers of tests, possibly no refrigeration or electricity, and unsophisticated technicians. a series of 5 prototype tests designed for african laboratories been evaluated at the Mama Yemo Hospital, Kinshasa, Zaire, under the auspices of Diagnostic Technology for Community Health (USAID-funded) and managed by PATH. Results comparable to those with ELISA could be achieved with duplicate testing, but the cost remained about the same. to lower final costs, development and overhead for the supplier must be carried by donor funds. With there criteria in mind, PATH is working on a public sector HIV test taking 30 minutes, costing US$.25 per test, requiring minimal equipment and training. A test using an 8-well blank with a comb containing solid phase HIV gp41 peptide, and read by color development, has shown promise. If it can be produced locally, it will cost about $US.14 per test. Such low-cost test kits may even cause the price of commercially available HIV tests to decline.

  11. Sexual behavior of HIV discordant couples after HIV counseling and testing.

    PubMed

    Allen, Susan; Meinzen-Derr, Jareen; Kautzman, Michele; Zulu, Isaac; Trask, Stanley; Fideli, Ulgen; Musonda, Rosemary; Kasolo, Francis; Gao, Feng; Haworth, Alan

    2003-03-28

    Sexual behavior following voluntary HIV counseling and testing (VCT) is described in 963 cohabiting heterosexual couples with one HIV positive and one HIV negative partner ('discordant couples'). Biological markers were used to assess the validity of self-report. Couples were recruited from a same-day VCT center in Lusaka, Zambia. Sexual exposures with and without condoms were recorded at 3-monthly intervals. Sperm detected on vaginal smears, pregnancy, and sexually transmitted diseases (STD) including HIV, gonorrhea, syphilis, and Trichomonas vaginalis were assessed. Less than 3% of couples reported current condom use prior to VCT. In the year after VCT, > 80% of reported acts of intercourse in discordant couples included condom use. Reporting 100% condom use was associated with 39-70% reductions in biological markers; however most intervals with reported unprotected sex were negative for all biological markers. Under-reporting was common: 50% of sperm and 32% of pregnancies and HIV transmissions were detected when couples had reported always using condoms. Positive laboratory tests for STD and reported extramarital sex were relatively infrequent. DNA sequencing confirmed that 87% of new HIV infections were acquired from the spouse. Joint VCT prompted sustained but imperfect condom use in HIV discordant couples. Biological markers were insensitive but provided evidence for a significant under-reporting of unprotected sex. Strategies that encourage truthful reporting of sexual behavior and sensitive biological markers of exposure are urgently needed. The impact of prevention programs should be assessed with both behavioral and biological measures.

  12. Use of a commercial serologic test for Angiostrongylus vasorum for the detection of A. chabaudi in wildcats and A. daskalovi in badgers.

    PubMed

    Deak, Georgiana; Gherman, Călin Mircea; Ionică, Angela Monica; Daskalaki, Aikaterini Alexandra; Matei, Ioana Adriana; D'Amico, Gianluca; Domşa, Cristian; Pantchev, Nikola; Mihalca, Andrei Daniel; Cozma, Vasile

    2017-01-15

    Three species of the genus Angiostrongylus are known to infect European carnivores: A. vasorum (mainly in canids but also in other carnivores), A. chabaudi (in felids) and A. daskalovi (in mustelids). A. vasorum is responsible for clinically severe disease in domestic dogs, most commonly diagnosed based on fecal examination and serological detection of circulating antigens. Considering the poorly known host range and the challenging larval differentiation in the feces between the three species of Angiostrongylus infecting European carnivores, our aim was to evaluate the cross-reactivity of A. chabaudi and A. daskalovi with A. vasorum using a commercial serologic test developed for domestic dogs. Badgers (Meles meles) (n=10) and wildcats (Felis silvestris) (n=8) were examined between 2015 and 2016 by full parasitological necropsy with subsequent morphological and molecular identification of nematodes and by serology, using IDEXX Angio Detect™ tests. Five out of the ten badgers and two out of the eight wildcats were harboring nematodes in the pulmonary arteries. All nematodes were identified morphologically as A. daskalovi in badgers and A. chabaudi in wildcats, respectively. Serological examination of the plasma samples revealed the positivity of the same animals as found in necropsy. None of the animals negative at necropsy was positive at serology. The 100% correlation between the necropsy results and the serologic positivity to IDEXX Angio Detect™ in badgers infected with A. daskalovi and wildcats infected with A. chabaudi suggest that these rapid tests are able to identify circulating antigens of all species of Angiostrongylus found in European carnivores: A. vasorum, A. daskalovi and A. chabaudi. The possibility for future in-clinic use of this test in domestic cats should be further investigated.

  13. Choice in HIV testing: the acceptability and anticipated use of a self-administered at-home oral HIV test among South Africans.

    PubMed

    Kelvin, Elizabeth A; Cheruvillil, Sonia; Christian, Stephanie; Mantell, Joanne E; Milford, Cecilia; Rambally-Greener, Letitia; Mosery, Nzwakie; Greener, Ross; Smit, Jennifer A

    2016-07-01

    Combination HIV prevention is being widely promoted by funders. This strategy aims to offer HIV prevention choices that can be selected and combined to decrease HIV risk in ways that fit with each individual's situation. Treatment as prevention and pre-exposure prophylaxis are two new evidence-based strategies to decrease HIV incidence, both of which require high HIV testing rates to be effective, and the Joint United Nations Programme on HIV/AIDS (UNAIDS) has set a goal of 90% of HIV-positive individuals knowing their status by 2030. However, HIV testing rates in many countries remain suboptimal. Just as no single HIV prevention method is ideal for all people in all situations, no single HIV testing modality is likely to be acceptable to everyone. By offering HIV testing choices, we may be able to increase testing rates. However, many low-resourced countries have been slow to take up new HIV testing options such as the self-administered at-home oral HIV test that is currently available in the United States. In this paper, we present findings from 20 in-depth interviews, conducted in 2010, documenting opinions about self-administered at-home oral HIV testing, a testing modality still largely unavailable in Africa. Participants were clients of three primary healthcare clinics in South Africa. Self-testing was seen as enabling confidentiality/privacy, saving time, and facilitating testing together with partners. However, concerns were raised about psychological distress when testing at home without a counsellor. Some suggested this concern could be minimised by having experienced clinic-based HIV testing and counselling before getting self-testing kits for home use. Thus, self-administered HIV testing could be an option added to the current testing modalities to address some important barriers to testing.

  14. Lack of HIV Testing and Awareness of HIV Infection among Men Who Have Sex with Men, Beijing, China

    ERIC Educational Resources Information Center

    Choi, Kyung-Hee; Lui, Hui; Guo, Yaqi; Han, Lei; Mandel, Jeffrey S.

    2006-01-01

    In China, men who have sex with men (MSM) are at high risk for HIV. However, little is known about their HIV testing behavior. From September 2001 to January 2002, we recruited 482 men through social networks and MSM venues. We conducted HIV testing and counseling, and anonymous, standardized face-to-face interviews. Eighty-two percent of…

  15. Lack of HIV Testing and Awareness of HIV Infection among Men Who Have Sex with Men, Beijing, China

    ERIC Educational Resources Information Center

    Choi, Kyung-Hee; Lui, Hui; Guo, Yaqi; Han, Lei; Mandel, Jeffrey S.

    2006-01-01

    In China, men who have sex with men (MSM) are at high risk for HIV. However, little is known about their HIV testing behavior. From September 2001 to January 2002, we recruited 482 men through social networks and MSM venues. We conducted HIV testing and counseling, and anonymous, standardized face-to-face interviews. Eighty-two percent of…

  16. Serological differentiation of Brucella-vaccinated and -infected domesticated animals by the agar gel immunodiffusion test using Brucella polysaccharide in mongolia.

    PubMed

    Erdenebaatar, Janchivdorj; Sugar, Sengee; Yondondorj, Agchbazar; Nagabayashi, Toshihiko; Syuto, Bunei; Watarai, Masahisa; Makino, Sou-Ichi; Shirahata, Toshikazu

    2002-09-01

    To investigate Brucella infection in cattle, sheep, goat, reindeer and yak in Mongolia, serological reactions of Brucella-infected and -vaccinated domestic animals were compared by the agar gel immunodiffusion (AGID) test with a polysaccharide (poly-B) of the B. Abortus strain S-19. The sensitivity and specificity were compared with conventional serological tests that are commonly used in Mongolia, such as the rose Bengal test, the tube agglutination test and the compliment fixation test. A total of 73.3, 100, 100, 95.8 and 61.9% of the sera from suspected cattle, yak, goat, sheep and reindeer, respectively, that were positive in the compliment fixation test, were also positive in the AGID test. Sera from vaccinated cattle, sheep and goat were positive over 90% by conventional tests 3 months after vaccination, but were negative by the AGID. These results suggest that the AGID test may be useful to differentiate infected and vaccinated animals in the field.

  17. The histrionic push for mandatory perinatal HIV testing.

    PubMed

    Hansen, E

    1997-01-01

    Voluntary HIV testing of newborns is driving down the rate of maternal-fetal transmission, although mandatory testing in other populations continues to be controversial. An amendment to the Ryan White CARE Act that encourages mandatory HIV testing of newborns, to be phased in over a four-year period, is being met with resistance from AIDS activists. The justification for mandatory testing is from a single trial, ACTG 076, that shows that HIV infection rates could be decreased two-thirds in newborns through the use of AZT during pregnancy and immediately after delivery. However, there has been no testing of AZT's potential toxicity in mothers or the long-term effects on babies. This also means that AZT monotherapy, much less effective than combination therapy, is only prescribed for pregnant women. Activists call for strategy sessions and grassroots organizations to defeat the trend toward mandatory testing in any population.

  18. Barriers and facilitators to voluntary HIV testing uptake among communities at high risk of HIV exposure in Chennai, India.

    PubMed

    Woodford, Michael R; Chakrapani, Venkatesan; Newman, Peter A; Shunmugam, Murali

    2015-08-28

    In India, increasing uptake of voluntary HIV testing among 'core risk groups' is a national public health priority. While HIV testing uptake has been studied among key populations in India, limited information is available on multi-level barriers and facilitators to HIV testing, and experiences with free, publicly available testing services, among key populations. We conducted 12 focus groups (n = 84) and 12 key informant interviews to explore these topics among men who have sex with men, transgender women, cisgender female sex workers, and injecting drug users in the city of Chennai. We identified inter-related barriers at social-structural, health-care system, interpersonal, and individual levels. Barriers included HIV stigma, marginalised-group stigma, discrimination in health-care settings, including government testing centres, and fears of adverse social consequences of testing HIV positive. Facilitators included outreach programmes operated by community-based/non-governmental organisations, accurate HIV knowledge and risk perception for HIV, and access to drug dependence treatment for injecting drug users. Promoting HIV testing among these key populations requires interventions at several levels: reducing HIV-related and marginalised-group stigma, addressing the fears of consequences of testing, promoting pro-testing peer and social norms, providing options for rapid and non-blood-based HIV tests, and ensuring non-judgmental and culturally competent HIV counselling and testing services.

  19. Evaluation of the Bio-Rad Multispot HIV-1/HIV-2 Rapid Test as an alternative to Western blot for confirmation of HIV infection.

    PubMed

    Cárdenas, Ana María; Baughan, Eleonore; Hodinka, Richard L

    2013-12-01

    In the United States, a new HIV diagnostic algorithm has been proposed that uses an HIV-1/HIV-2 antibody differentiation immunoassay instead of Western blot or immunofluoresence for confirmatory testing. To evaluate the Multispot HIV-1/HIV-2 Rapid Test (Multispot) as an alternative to Western blot analysis for confirmation of HIV infection. A series of 205 serum and plasma specimens positive for HIV-1 or HIV-2 were used to compare the performance of Multispot to a standard HIV-1 Western blot. Positive samples included 63 specimens from patients>18 months of age, 33 proficiency survey specimens, and 109 specimens from nine commercial seroconversion and performance panels. In addition, 63 specimens from 51 HIV-exposed, uninfected children≤18 months of age in various stages of seroreversion and 192 HIV-negative samples were tested. Specimens were initially screened using a 4th generation HIV Ag/Ab Combo assay. Multispot readily discriminated between individuals with HIV-1 or HIV-2 infection and those who were uninfected. Of the 205 samples repeatedly reactive by the 4th generation screening assay, infection status was correctly confirmed by Multispot in 83.9% (172/205) compared to 68.8% (141/205) for Western blot. Multispot detected HIV-1 earlier in 27.6% of low-titer antibody specimens called indeterminate by Western blot, and effectively reduced the number of indeterminate results in seroreverting HIV-1 exposed, uninfected infants and for HIV-2 infections misinterpreted as indeterminate or positive by HIV-1 Western blot. Multispot offers speed and simplicity over Western blot and has an excellent performance for differentiation and confirmation of antibodies to HIV-1 and HIV-2. Copyright © 2013 Elsevier B.V. All rights reserved.

  20. Difficulties in the diagnosis of HTLV-2 infection in HIV/AIDS patients from Brazil: comparative performances of serologic and molecular assays, and detection of HTLV-2b subtype.

    PubMed

    Morimoto, Helena Kaminami; Morimoto, Arilson Akira; Reiche, Edna Maria Vissoci; Ueda, Luiz Toshio; Matsuo, Tiemi; Reiche, Fernando Vissoci; Caterino-de-Araujo, Adele

    2007-01-01

    The current diagnosis of human T-lymphotropic virus type-2 (HTLV-2) infection is based on the search of specific antibodies; nevertheless, several studies conducted in Brazil pointed deficiencies of the commercially available kits in detecting HTLV-2, mostly in HIV/AIDS patients. This study searched for the presence of HTLV-1 and -2 in 758 HIV/AIDS patients from Londrina, Paraná, Brazil. Serum samples were screened for HTLV-1/2 antibodies using two EIA kits (Vironostika and Murex), and confirmed by WB (HTLV Blot 2.4, Genelabs). The results obtained by EIA disclosed 49 (6.5%) reactive sera: 43 positive by both EIA kits, and six with discordant results. WB confirmed HTLV-1 infection in seven samples (0.9%) and HTLV-2 in 21 sera (2.8%). Negative and indeterminate results were detected in four (0.5%) and 16 (2.1%) sera, respectively. Blood from 47 out of 49 HTLV seroreactive patients were collected and analyzed for the presence of env, LTR and tax genomic segments of HTLVs by PCR. PCR confirmed six cases of HTLV-1 and 37 cases of HTLV-2 infection (14 out of 16 that were found to be WB indeterminate). Restriction analysis of the env PCR products of HTLV-2 disclosed 36 isolates of HTLV-2a/c subtype, and one of HTLV-2b subtype. These results emphasize the need of improving serologic tests for detecting truly HTLV-2 infected patients from Brazil, and confirm the presence of HTLV-2b subtype in the South of this country.

  1. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  2. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  3. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  4. 42 CFR 493.923 - Syphilis serology.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Syphilis serology. 493.923 Section 493.923 Public... Proficiency Testing Programs by Specialty and Subspecialty § 493.923 Syphilis serology. (a) Program content and frequency of challenge. To be approved for proficiency testing in syphilis serology, a...

  5. Factors Associated with HIV Prevalence and HIV Testing in Sierra Leone: Findings from the 2008 Demographic Health Survey

    PubMed Central

    Brima, Nataliya; Burns, Fiona; Fakoya, Ibidun; Kargbo, Brima; Conteh, Suleiman; Copas, Andrew

    2015-01-01

    Background The Sierra Leone Demographic Health Survey 2008 found an HIV prevalence of 1.5%. This study investigates associations with HIV infection and HIV testing. Methods Households were selected using stratified multi-stage sampling. In all selected households women aged 15–49 were eligible. In every second household men aged 15–59 were also eligible. Participants were asked to consent for anonymous HIV testing. All participants interviewed and tested were analysed. Multiple logistic regression identified associations with HIV infection, undiagnosed infection and with ever having a voluntary HIV test among sexually active participants. Results Of 7495 invited 86% (6,475) agreed to an interview and HIV test. Among 96 HIV positive participants, 78% had never taken a voluntary HIV test so were unaware of their serostatus, and 86% were sexually active in the last 12 months among whom 96% did not use a condom at last intercourse. 11% of all participants had previously voluntarily tested. Among women who had tested, 60% did so in antenatal care. We found that those living in an urban area, and those previously married, were more likely to be HIV infected. Voluntary HIV testing was more common in those aged 25–44, living in an urban area, females, having secondary or higher education, having first sexual intercourse at age 17 years or older, and using condoms at last sex. Although 82% of men and 69% of women had heard of HIV, only 35% and 29% respectively had heard of antiretroviral therapy. Conclusions The HIV prevalence in Sierra Leone has been stable. HIV testing, however, is uncommon and most infected individuals are unaware of their serostatus. This could allow the epidemic to escalate as individuals with undiagnosed infection are unlikely to change their behaviour or access treatment. Improving knowledge and increasing testing need to remain central to HIV prevention interventions in Sierra Leone. PMID:26452051

  6. Why do marital partners of people living with HIV not test for HIV? A qualitative study in Lusaka, Zambia.

    PubMed

    Musheke, Maurice; Merten, Sonja; Bond, Virginia

    2016-08-25

    Knowledge of HIV status is crucial for HIV prevention and management in marital relationships. Yet some marital partners of people living with HIV decline HIV testing despite knowing the HIV-positive status of their partners. To date, little research has explored the reasons for this. An exploratory qualitative study was undertaken in Lusaka, Zambia, between March 2010 and September 2011, nested within a larger ethnographic study. In-depth interviews were held with individuals who knew the HIV-positive status of their marital partners but never sought HIV testing (n = 30) and HIV service providers of a public sector clinic (n = 10). A focus group discussion was also conducted with eight (8) lay HIV counsellors. Data was transcribed, coded and managed using ATLAS.ti and analysed using latent content analysis. The overarching barrier to uptake of HIV testing was study participants' perception of their physical health, reinforced by uptake of herbal remedies and conventional non-HIV medication to mitigate perceived HIV-related symptoms. They indicated willingness to test for HIV if they noticed a decline in physical health and other alternative forms of care became ineffective. Also, some study participants viewed themselves as already infected with HIV on account of the HIV-positive status of their marital partners, with some opting for faith healing to get 'cured'. Other barriers were the perceived psychological burden of living with HIV, modulated by lay belief that knowledge of HIV-positive status led to rapid physical deterioration of health. Perceived inability to sustain uptake of life-long treatment - influenced by a negative attitude towards treatment - further undermined uptake of HIV testing. Self-stigma, which manifested itself through fear of blame and a need to maintain moral credibility in marital relationships, also undermined uptake of HIV testing. Improving uptake of HIV testing requires a multi-pronged approach that addresses self-stigma, lay risk

  7. At-risk groups buy home HIV blood tests.

    PubMed

    1997-02-01

    Twenty thousand HIV-antibody home blood testing kits have been sold, primarily to customers in high risk groups, gays, blacks, and Hispanics. The telephone counseling provided by the test makers gets high grades from the Centers for Disease Control and Prevention (CDC) Division for HIV/AIDS Prevention, with test buyers staying on the phone from 20 minutes to over an hour. Using the lancet for blood collection is working well, with 99 percent of cases getting a large enough volume to sample. There are 3 approved test kits: Confide, Home Access, and Home Access Express.

  8. HIV testing behaviors and attitudes among community recruited methamphetamine users in a South African township

    PubMed Central

    Meade, Christina S.; Towe, Sheri L.; Watt, Melissa H.; Hobkirk, Andrea; Skinner, Donald; Myers, Bronwyn; Kimani, Stephen M.; Pieterse, Desiree

    2015-01-01

    Background Methamphetamine users in South Africa are at high risk for HIV infection and transmission, but little is known about HIV testing in this population. Methods We examined HIV testing behaviors and attitudes in 362 methamphetamine users recruited using chain referral sampling from one peri-urban community. Results Many (44%) had not been HIV tested in the past year. HIV testing was associated with positive testing attitudes, less AIDS stigma, and greater methamphetamine stigma. Among participants who reported HIV infection (8%), less than half were linked to care. Conclusions Findings highlight the need to identify barriers to HIV service uptake for methamphetamine users. PMID:24858393

  9. Predictors of HIV Testing and Intention to Test Among Hispanic Farmworkers in South Florida

    ERIC Educational Resources Information Center

    Fernandez, M. Isabel; Collazo, Jose B.; Bowen, G. Stephen; Varga, Leah M.; Hernandez, Nilda; Perrino, Tatiana

    2005-01-01

    Context and Purpose: This study examined the predictors of HIV testing and factors associated with intention to accept a free HIV test among 244 Hispanic migrant/seasonal farmworkers in South Florida. Methods: Time and space sampling procedures were used to recruit participants in public venues. Bilingual staff interviewed eligible respondents in…

  10. Predictors of HIV Testing and Intention to Test Among Hispanic Farmworkers in South Florida

    ERIC Educational Resources Information Center

    Fernandez, M. Isabel; Collazo, Jose B.; Bowen, G. Stephen; Varga, Leah M.; Hernandez, Nilda; Perrino, Tatiana

    2005-01-01

    Context and Purpose: This study examined the predictors of HIV testing and factors associated with intention to accept a free HIV test among 244 Hispanic migrant/seasonal farmworkers in South Florida. Methods: Time and space sampling procedures were used to recruit participants in public venues. Bilingual staff interviewed eligible respondents in…

  11. FAITH - Fast Assembly Inhibitor Test for HIV.

    PubMed

    Hadravová, Romana; Rumlová, Michaela; Ruml, Tomáš

    2015-12-01

    Due to the high number of drug-resistant HIV-1 mutants generated by highly active antiretroviral therapy (HAART), there is continuing demand for new types of inhibitors. Both the assembly of the Gag polyprotein into immature and mature HIV-1 particles are attractive candidates for the blocking of the retroviral life cycle. Currently, no therapeutically-used assembly inhibitor is available. One possible explanation is the lack of a reliable and simple assembly inhibitor screening method. To identify compounds potentially inhibiting the formation of both types of HIV-1 particles, we developed a new fluorescent high-throughput screening assay. This assay is based on the quantification of the assembly efficiency in vitro in a 96-well plate format. The key components of the assay are HIV-1 Gag-derived proteins and a dual-labelled oligonucleotide, which emits fluorescence only when the assembly of retroviral particles is inhibited. The method was validated using three (CAI, BM2, PF74) reported assembly inhibitors. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  12. A TEST OF TWO HIV DISCLOSURE THEORIES

    PubMed Central

    2005-01-01

    The purpose of this study was to examine two theories of HIV disclosure. The first is a disease progression theory and the second is the theory of competing consequences. Participants were 138 HIV-positive gay men involved in a larger study of HIV disclosure. Structural equation modeling was used to analyze each model, with the root mean square error of approximation (RMSEA) and the nonnormed fit index (NNFI) used to evaluate goodness of fit. The RMSEA for the disease progression model was .031 and the NNFI was .932. The RMSEA for the consequences model was .018 and NNFI was .978. Both indices are considered to be a close fit; however, the parameter estimates for disease progression to disclosure in the disease model and disease progression to consequences in the consequences model were nonsignificant, suggesting that disease progression may not play a role in the decision to disclose an HIV diagnosis. Researchers may want to focus on the intentions and possible outcomes from disclosure as predictive factors. PMID:11565594

  13. Rapid enzymatic test for phenotypic HIV protease drug resistance.

    PubMed

    Hoffmann, Dieter; Assfalg-Machleidt, Irmgard; Nitschko, Hans; von der Helm, Klaus; Koszinowski, Ulrich; Machleidt, Werner

    2003-07-01

    A phenotypic resistance test based on recombinant expression of the active HIV protease in E. coli from patient blood samples was developed. The protease is purified in a rapid one-step procedure as active enzyme and tested for inhibition by five selected synthetic inhibitors (amprenavir, indinavir, nelfinavir, ritonavir, and saquinavir) used presently for chemotherapy of HIV-infected patients. The HPLC system used in a previous approach was replaced by a continuous fluorogenic assay suitable for high-throughput screening on microtiter plates. This reduces significantly the total assay time and allows the determination of inhibition constants (Ki). The Michaelis constant (Km) and the inhibition constant (Ki) of recombinant wild-type protease agree well with published data for cloned HIV protease. The enzymatic test was evaluated with recombinant HIV protease derived from eight HIV-positive patients scored from 'sensitive' to 'highly resistant' according to mutations detected by genotypic analysis. The measured Ki values correlate well with the genotypic resistance scores, but allow a higher degree of differentiation. The non-infectious assay enables a more rapid yet sensitive detection of HIV protease resistance than other phenotypic assays.

  14. [Impediments to HIV testing in HIV-infected children and teenagers in Africa: look for them where they are!].

    PubMed

    Msellati, P; Ateba Ndongo, F; Hejoaka, F; Nacro, B

    2016-01-01

    A huge number of HIV-infected children and teenagers have no access to care or receive it very late. Of the 3.2 million infected children, 2.8 million should be receiving highly active antiretroviral treatment (HAART) but only around 700,000 actually are. The first reason for this failure is the lack of HIV testing among HIV-exposed infants and thus early diagnosis or, even more frequently, the lack of testing among older children and teenagers. The objectives of this article are twofold: to review the current situation and to advocate routine offers of HIV testing to HIV-exposed children and teenagers (exposed either through mother-to-child transmission or repeated transfusions) and those suspected to be HIV-infected (because of malnutrition, tuberculosis, or other associated diseases). Finally, adults living with HIV should be made aware of the need for routine HIV screening of their children, even when asymptomatic.

  15. Low Health Literacy Is Associated with HIV Test Acceptance

    PubMed Central

    Barragán, Maribel; Hicks, Giselle; Williams, Mark V; Franco-Paredes, Carlos; Duffus, Wayne; del Rio, Carlos

    2005-01-01

    Background The Centers for Disease Control and Prevention has proposed increasing the proportion of people who learn their HIV serostatus. The health care setting represents a logical site to accomplish this goal. However, little is known about factors that determine acceptability of HIV testing in health care settings, particularly patients' health literacy. Objective To evaluate the association between patients' health literacy and acceptance of HIV testing among individuals at an urgent care center (UCC). Methods As part of a prospective study that sought to increase HIV testing at a UCC located in an inner-city hospital serving an indigent population, we surveyed patients who had been offered an HIV test by their providers and had accepted or refused testing. Pretest counseling was provided using a low-literacy brochure given to patients upon registration into the clinic. We measured health literacy level using the Rapid Estimate of Adult Literacy in Medicine (REALM) scale. Results Three hundred seventy-two patients were enrolled in the study. In univariate analysis, no statistically significant difference between HIV test acceptors or refusers was found for gender, race/ethnicity, marital status, income, type of health insurance, educational level, or type of test offered. Acceptors were more likely to have a low literacy level (odds ratio [OR], 1.763; 95% confidence interval [CI], 1.084 to 2.866) and be less than 40 years old (OR, 1.639; 95% CI, 1.085 to 2.475). In multivariate analysis, low health literacy was shown to be a predictor of HIV test acceptance controlling for age and education (OR, 2.017; 95% CI, 1.190 to 3.418). Conclusions Low health literacy was shown to be a predictor of HIV test acceptance. Patients presenting to a UCC with poorer health literacy appear more willing to comply with health care providers' recommendations to undergo HIV testing than those with adequate health literacy when an “opt-out” strategy combined with a low

  16. Development of a virus neutralisation test to detect antibodies against Schmallenberg virus and serological results in suspect and infected herds.

    PubMed

    Loeffen, Willie; Quak, Sjaak; de Boer-Luijtze, Els; Hulst, Marcel; van der Poel, Wim; Bouwstra, Ruth; Maas, Riks

    2012-08-07

    At the end of 2011, a new orthobunyavirus, tentatively named Schmallenberg virus (SBV), was discovered in Germany. This virus has since been associated with clinical signs of decreased milk production, watery diarrhoea and fever in dairy cows, and subsequently also with congenital malformations in calves, lambs and goat kids. In affected countries, initial surveillance for the infection was based on examination of malformed progeny. These suspicions were followed up by real-time reverse transcription polymerase chain reaction (RT-PCR) on brain tissue. For epidemiological purposes, a serological assay was, however, needed. A virus neutralisation test (VNT) was developed and optimized, and subsequently evaluated. This VNT has a specificity of >99% and the sensitivity is likely also very close to 100%. The assay is highly repeatable and reproducible. The final assay was used to test for antibodies in cows, ewes and does from herds known to be infected or suspected to be so. Targets for sampling in these herds were the mothers of malformed offspring. In herds with an RT-PCR confirmed SBV infection, more than 94% (190 out of 201) of the ewes and 99% (145 out of 146) of the cows were seropositive. In herds with suspicion of SBV infection based on birth of malformed offspring only (no or negative RT-PCR), more than 90% (231 out of 255) of the ewes and 95% (795 out of 834) of the cows were seropositive. In goats, on the other hand, only a low number of seropositives was found: overall 36.4%, being 16 out of 44 goats tested. Given the characteristics of this VNT, it can be used at a relative high throughput for testing of animals for export, surveillance, screening and research purposes, but can also be used as a confirmation test for commercially available enzyme-linked immunosorbent assays (ELISA's) and for (relative) quantification of antibodies.Suspicions of SBV infections that were confirmed by RT-PCR were almost always confirmed by serology in cows. Due to individual

  17. Assessment of linkages from HIV testing to enrolment and retention in HIV care in Central Mozambique

    PubMed Central

    Inguane, Celso Azarias; Gloyd, Stephen; Manuel, João Luis; Brown, Charlene; Wong, Vincent; Augusto, Orvalho; Hassan, Wisal Mustafa; Vieira, Lúcia; Afonso, Pires; Jamnadás, Mehol; Bernard, Jama Joy; Cowan, James; Kalibala, Samuel; Pfeiffer, James

    2016-01-01

    Introduction Effectiveness of the rapid expansion of antiretroviral therapy (ART) throughout sub-Saharan Africa is highly dependent on adequate enrolment and retention in HIV care. However, the measurement of both has been challenging in these settings. This study aimed to assess enrolment and retention in HIV care (pre-ART and ART) among HIV-positive adults in Central Mozambique, including identification of barriers and facilitators. Methods We assessed linkages to and retention in HIV care using a mixed quantitative and qualitative approach in six districts of Manica and Sofala provinces. We analyzed routine district and health facility monthly reports and HIV care registries from April 2012 to March 2013 and used single imputation and trimmed means to adjust for missing values. In eight health facilities in the same districts and period, we assessed retention in HIV care among 795 randomly selected adult patient charts (15 years and older). We also conducted 25 focus group discussions and 53 in-depth interviews with HIV-positive adults, healthcare providers and community members to identify facilitators and barriers to enrolment and retention in HIV care. Results Overall, 46% of the monthly HIV testing reports expected at the district level were missing, compared to 6.4% of the pre-ART registry reports. After adjustment for missing values, we estimated that the aggregate numbers of adults registered in pre-ART was 75% of the number of persons tested HIV-positive in the six districts. In the eight health facilities, 40% of the patient charts for adults enrolled in pre-ART and 44% in ART were missing. Of those on ART for whom charts were found, retention in treatment within 90 and 60 days prior to the study team visit was 34 and 25%, respectively. Combining these multiple data sources, the overall estimated retention was 18% in our sample. Individual-level factors were perceived to be key influences to enrolment in HIV care, while health facility and structural

  18. Application of Rapid Serologic Tests for Detection of Mycobacterium bovis Infection in Free-Ranging Warthogs (Phacochoerus africanus)--Implications for Antemortem Disease Screening.

    PubMed

    Miller, Michele; Buss, Peter; de Klerk-Lorist, Lin-Mari; Hofmeyr, Jennifer; Hausler, Guy; Lyashchenko, Konstantin; Lane, Emily P; Botha, Louise; Parsons, Sven; van Helden, Paul

    2016-01-01

    Warthogs (Phacochoerus africanus) have been implicated as potential maintenance hosts of Mycobacterium bovis. Our preliminary investigation of bovine tuberculosis in three warthogs describes pathologic findings and associated positive serologic results in two infected animals. This demonstrates the potential use of serodiagnostic tests for M. bovis infection in this species.

  19. Prevalence of human immunodeficiency virus, hepatitis C virus, hepatitis B virus and syphilis among individuals attending anonymous testing for HIV in Luanda, Angola.

    PubMed

    Guimarães Nebenzahl, H; Lopes, A; Castro, R; Pereira, F

    2013-01-24

    Human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis remain major infections around the world. In Angola there are about 166 000 individuals living with HIV, representing a prevalence of 1.98% in adults between 15 and 49 years of age. In a 2003 study in Luanda, 4.5% of pregnant women had antibodies to HIV and 8.1% to HBV, and 5.4% were infected with Treponema pallidum. Objectives. The aim of this study was to determine the prevalence of HIV-1 and 2, HBV, HCV and T. pallidum serological markers, and hence the prevalence of these infections, in individuals attending a sexually transmitted disease clinic in Luanda, Angola, and the burden of these infections in the Angolan population. Methods. Individuals attending a centre for anonymous testing for HIV were randomly included in the study. All samples were tested for HBV surface antigen (HBsAg), anti-HCV and anti-HIV-1 and 2 antibodies and antibodies to T. pallidum. Results. A total of 431 individuals (262 women and 169 men) were studied, of whom 10.0% (43/431) were seropositive for T. pallidum and 4.6% had active syphilis; 8.8% (38/431) were seropositive for HIV-1 and/or HIV-2 (of these, 78.9% were HIV-1-positive, 2.6% HIV-2-positive and 18.4% co-infected); 9.3% (40/431) were HBsAg-positive, while 8.1% (35/431) had antibodies to HCV. Of 102 patients with positive results, 26 (25.5%, or 6.0% of the total of 431 patients) were positive for more than one of the organisms studied. Rates of co-infection were as follows: 2.3% (10/431) for HIV/HBV, 0.9% (4/431) for HIV/HCV, and 0.9% (4/431) for HCV/HBV. Three individuals with active syphilis had viral co-infection, hepatitis B in 1 case and HIV in 2. Five individuals (1.2% of the total) were seropositive for three infections, HIV, hepatitis B and hepatitis C in 3 cases and HIV, hepatitis C and syphilis in 2. Conclusions. A high prevalence of co-infection with the infections studied was found in this population, including HIV

  20. Aspects of the Italian legislation related to HIV testing.

    PubMed

    D'Amato, Stefania; Pompa, Maria Grazia

    2010-01-01

    Italy has adhered to international declarations regarding the prevention, care, and treatment of HIV/AIDS and has adopted the fundamental interventions for surveillance and control; access to testing is defined by Law 135 of 5 June 1990. At the time, the Ministry of Health issued decrees to define national epidemiological surveillance systems for new HIV infections. The decree provides indications on the data to be collected, data flow, the modes of data transmission respecting security measures and some recommendations regarding access to HIV testing. It is thus necessary to develop national recommendations on appropriate methods for considering the diverse phases of access to testing in relation to the level of awareness of the minor, the outcome and divulging of the test.

  1. HIV Testing, HIV Positivity, and Linkage and Referral Services in Correctional Facilities in the United States, 2009–2013

    PubMed Central

    Seth, Puja; Figueroa, Argelia; Wang, Guoshen; Reid, Laurie; Belcher, Lisa

    2016-01-01

    Background Because of health disparities, incarcerated persons are at higher risk for multiple health issues, including HIV. Correctional facilities have an opportunity to provide HIV services to an underserved population. This article describes Centers for Disease Control and Prevention (CDC)–funded HIV testing and service delivery in correctional facilities. Methods Data on HIV testing and service delivery were submitted to CDC by 61 health department jurisdictions in 2013. HIV testing, HIV positivity, receipt of test results, linkage, and referral services were described, and differences across demographic characteristics for linkage and referral services were assessed. Finally, trends were examined for HIV testing, HIV positivity, and linkage from 2009 to 2013. Results Of CDC-funded tests in 2013 among persons 18 years and older, 254,719 (7.9%) were conducted in correctional facilities. HIV positivity was 0.9%, and HIV positivity for newly diagnosed persons was 0.3%. Blacks accounted for the highest percentage of HIV-infected persons (1.3%) and newly diagnosed persons (0.5%). Only 37.9% of newly diagnosed persons were linked within 90 days; 67.5% were linked within any time frame; 49.7% were referred to partner services; and 45.2% were referred to HIV prevention services. There was a significant percent increase in HIV testing, overall HIV positivity, and linkage from 2009 to 2013. However, trends were stable for newly diagnosed persons. Conclusions Identification of newly diagnosed persons in correctional facilities has remained stable from 2009 to 2013. Correctional facilities seem to be reaching blacks, likely due to higher incarceration rates. The current findings indicate that improvements are needed in HIV testing strategies, service delivery during incarceration, and linkage to care postrelease. PMID:26462190

  2. The relationships between the HIV test interval, demographic factors and HIV disease progression.

    PubMed Central

    2001-01-01

    Individuals developing an HIV seroconversion illness may experience rapid disease progression. Information on seroconversion illness is rarely collected in most cohort studies, thus the aim of this study was to assess the value of the HIV test interval (the time between last negative and first positive HIV tests) as a proxy for seroconversion illness. Among 8229 seroconverters, test intervals ranged from 0-5282 days, and varied by gender, risk group, age and calendar year of seroconversion. Those with intervals < or = 31 days had an increased hazard of AIDS (RH 1.42, P = 0.07), which was reduced slightly after adjusting for baseline factors, calendar year of follow-up, treatment and the declining CD4 count, but there was no effect on survival. Thus, it appears that if information on acute seroconversion illness is not available, then analyses of progression to AIDS in seroconverter studies could use a short test interval as a proxy measure. PMID:11561980

  3. Performance of commercially available serological diagnostic tests to detect Leishmania infantum infection on experimentally infected dogs.

    PubMed

    Rodríguez-Cortés, Alhelí; Ojeda, Ana; Todolí, Felicitat; Alberola, Jordi

    2013-01-31

    Leishmania infantum (syn. Leishmania chagasi) is the etiological agent of a widespread serious zoonotic disease that affects both humans and dogs. Prevalence and incidence of the canine infection are important parameters to determine the risk and the ways to control this reemergent zoonosis. Unfortunately, there is not a gold standard test for Leishmania infection. Our aim was to assess the operative validity of commercial tests used to detect antibodies to Leishmania in serum samples from experimental infections. Three ELISA tests (LEISCAN(®) Leishmania ELISA Test, INGEZIM(®) LEISHMANIA, and INGEZIM(®) LEISHMANIA VET), three immunochromatographic tests (INGEZIM(®) LEISHMACROM, SNAP(®) Leishmania, and WITNESS(®) Leishmania), and one IFAT were evaluated. LEISCAN(®) Leishmania ELISA test achieved the highest sensitivity and accuracy (both 0.98). Specificity was 1 for all tests except for IFAT. All tests but IFAT obtained a positive predictive value of 1, while the maximum negative predictive value was achieved by LEISCAN(®) Leishmania ELISA Test (0.93). The best positive likelihood ratio was obtained by INGEZIM(®) LEISHMANIA VET (30.26), while the best negative likelihood ratio was obtained by LEISCAN(®) Leishmania ELISA Test (0.02). The highest diagnostic odds ratio was achieved by LEISCAN(®) Leishmania ELISA Test (729.00). The largest area under the ROC curve was obtained by LEISCAN(®) Leishmania ELISA Test (0.981). Quantitative ELISA based tests performmed better than qualitative tests ("Rapid Tests"), and the test best suited to detect Leishmania in infected dogs and to provide clinically useful information was LEISCAN(®) Leishmania ELISA Test. This and other results point also to the need of revising the status of IFAT as a gold standard for the diagnosis of leishmaniasis.

  4. HIV testing for HIV prevention: a comparative analysis of policies in Britain, Hungary and Sweden.

    PubMed

    Danziger, R

    1998-10-01

    This paper compares policies on named HIV testing in the context of HIV prevention in Britain, Hungary and Sweden, and considers the extent to which these policies are based on evidence of effectiveness or on other, more contextual, factors. In Britain, testing has not featured significantly as a prevention strategy, and named testing has generally been carried out only with the voluntary, informed consent of individuals. In Hungary, testing is central to HIV prevention, and is required by law of certain groups. HIV testing is carried out mainly on a voluntary basis in Sweden, but, unlike in Britain, it has been actively promoted by public health authorities. The paper contrasts the 'right not to know' one's HIV status which is widely respected in Britain, with the 'responsibility to find out' which is more pervasive in Hungary and Sweden. Although policy makers in all three countries appear convinced that their's is the right approach, there appears to be as yet a dearth of convincing evidence to support their arguments.

  5. Can Home-Based HIV Rapid Testing Reduce HIV Disparities Among African Americans in Miami?

    PubMed

    Kenya, Sonjia; Okoro, Ikenna S; Wallace, Kiera; Ricciardi, Michael; Carrasquillo, Olveen; Prado, Guillermo

    2016-09-01

    Sixty percent of African Americans have had an HIV test, yet this population disproportionately contributes to AIDS mortality, suggesting that testing is not occurring early enough to achieve optimal outcomes. OraQuick, the first Food and Drug Administration-approved home-based HIV rapid test (HBHRT) could potentially increase testing rates. We assessed whether community health workers (CHWs) paired with HBRHT could improve HIV screening and health care access among African Americans in Miami, Florida. In October-November 2013, 60 African Americans were enrolled and randomized to the experimental condition, which received CHW assistance to complete HBHRT, or the control condition, which were instructed to complete HBHRT independently. Intervention participants were significantly (p ≤ .05) more likely than control participants to complete HBHRT and, if positive, get linked to HIV care (100% vs. 83%) χ(2) (1, N = 60) = 5.46, p ≤ .02. We concluded that CHW-assisted HBHRT may be a promising strategy to improve HIV testing and care among African Americans.

  6. Point-of-care HIV tests done by peers, Brazil.

    PubMed

    Pascom, Ana Roberta Pati; Dutra de Barros, Clarissa Habckost; Lobo, Tainah Dourado de Miranda; Pasini, Elisiane Nelcina; Comparini, Regina Aparecida; Caldas de Mesquita, Fábio

    2016-08-01

    Early diagnosis of infections with human immunodeficiency virus (HIV) is needed - especially among key populations such as sex workers, transgender people, men who have sex with men and people who use drugs. The Brazilian Ministry of Health developed a strategy called Viva Melhor Sabendo ("live better knowing") to increase HIV testing among key populations. In partnership with nongovernmental organizations (NGOs), a peer point-of-care testing intervention, using an oral fluid rapid test, was introduced at social venues for key populations at different times of the day. Key populations in Brazil can have 40 times higher HIV prevalence than the general population (14.8% versus 0.4%). Legislation was reinterpreted, so that oral fluid rapid tests could be administered by any person trained in rapid testing by the health ministry. Between January 2014 and March 2015, 29 723 oral fluid tests were administered; 791 (2.7%) were positive. Among the key populations, transgender people had the greatest proportion of positive results (10.7%; 172/1612), followed by men who declared themselves as commercial sex workers (8.7%; 165/1889) and men who have sex with men (4.8%; 292/6055). The strategy improved access to HIV testing. Testing done by peers at times and locations suitable for key populations increased acceptance of testing. Working with relevant NGOs is a useful approach when reaching out to these key populations.

  7. Point-of-care HIV tests done by peers, Brazil

    PubMed Central

    Dutra de Barros, Clarissa Habckost; Lobo, Tainah Dourado de Miranda; Pasini, Elisiane Nelcina; Comparini, Regina Aparecida; Caldas de Mesquita, Fábio

    2016-01-01

    Abstract Problem Early diagnosis of infections with human immunodeficiency virus (HIV) is needed – especially among key populations such as sex workers, transgender people, men who have sex with men and people who use drugs. Approach The Brazilian Ministry of Health developed a strategy called Viva Melhor Sabendo (“live better knowing”) to increase HIV testing among key populations. In partnership with nongovernmental organizations (NGOs), a peer point-of-care testing intervention, using an oral fluid rapid test, was introduced at social venues for key populations at different times of the day. Local setting Key populations in Brazil can have 40 times higher HIV prevalence than the general population (14.8% versus 0.4%). Relevant changes Legislation was reinterpreted, so that oral fluid rapid tests could be administered by any person trained in rapid testing by the health ministry. Between January 2014 and March 2015, 29 723 oral fluid tests were administered; 791 (2.7%) were positive. Among the key populations, transgender people had the greatest proportion of positive results (10.7%; 172/1612), followed by men who declared themselves as commercial sex workers (8.7%; 165/1889) and men who have sex with men (4.8%; 292/6055). Lessons learnt The strategy improved access to HIV testing. Testing done by peers at times and locations suitable for key populations increased acceptance of testing. Working with relevant NGOs is a useful approach when reaching out to these key populations. PMID:27516641

  8. Utility of Serological Tests in the Era of Molecular Testing for Diagnosis of Human Brucellosis in Endemic Area with Limited Resources

    PubMed Central

    Metgud, Sharada C.; Mutnal, Manohar B; Nagamoti, Mahantesh B; Patil, Chidanand S.

    2016-01-01

    Background The culture has always been the gold standard test for diagnosis of human brucellosis but the conventional Brucella diagnostic tests viz. serology and culture are often beset with poor specificity & sensitivity respectively. The culture positivity rates for Brucella vary from 92% for bone marrow to 10% for non-blood samples and also dependent on the type of sample. The primary immune-determinant for Brucella species is the cell wall surface lipopolysaccharide, which is antigenically similar to other gram-negative rods. Hence, Brucella serological tests cross react with Escherichia coli 0116 and 0157, Salmonella urbana, Yersinia enterocolitica 0:9, Vibrio cholerae, Xanthomonas maltophilia and Afipia clevellandensis infections, which are common in developing countries also having higher incidence of brucellosis. Aim The aim of the study was evaluation of conventional serological techniques and PCR for diagnosis of human brucellosis in and around north Karnataka which is endemic for brucellosis and patients often present with elevated base line antibody titers and confounding clinical manifestations. Materials and Methods Blood/serum samples of 400 patients suffering from acute undifferentiated fever (AUF) were subjected to culture, Brucella slide agglutination test (SAT), standard tube agglutination test (STAT coupled with 2 ME) and PCR. Results Of the 400 AUF patients, anti-Brucella antibodies were detected by SAT and STAT in serum of 35 and 34 patients respectively. IS711 gene for Brucella was identified in 32 patients by PCR. Twenty samples yielded Brucella in culture on biphasic medium with average incubation period of 9 days. All patients having titer of ≥ 160IU / ml in STAT were found positive by PCR also. Conclusion Brucella STAT corroborated well with PCR results in all those cases where antibodies were present at least one dilution above cut-off value of 80 IU/ml. We probably need to raise cut-off titers to ≥160 IU/ml because of endemic region

  9. Impact of HIV/sexually transmitted infection testing on risky sexual behaviors among men who have sex with men in Langfang, China.

    PubMed

    Guo, Wei; Wu, Zun-You; Song, Ai-Jun; Poundstone, Katharine

    2013-04-01

    Men who have sex with men (MSM) in China remain at high risk for HIV infection, the proportion of reported HIV/AIDS cases that occurred among MSM rose greatly from 2005 to 2011. HIV testing and counseling is a critical HIV prevention strategy among HIV related high-risk population, including MSM in China. This article aimed to assess the association between receiving HIV testing and high-risk sexual behaviors among MSM in Langfang, Hebei Province, China. Between September and November 2007, 233 MSM were recruited to receive an HIV testing intervention. Face-to-face interviews were conducted before HIV testing and 3 months later HIV-related risk behaviors were assessed. Serological testing for HIV and other sexually transmitted infections (STIs) was performed. Of the recruited 233 MSM, 200 completed follow-up. Baseline prevalence was 7.8% for HIV, 21.0% for syphilis, 15.8% for gonorrhea, and 5.0% for chlamydia. Multivariate analysis indicated that inconsistent condom use (OR = 7.9, 95%CI: 0.9 - 66.7, P = 0.059) and bleeding during anal sex (OR = 5.9, 95%CI: 1.3 - 26.2, P = 0.019) were risk factors for HIV infection, and group sex (OR = 6.6, 95%CI: 2.2 - 19.7, P = 0.001) was a risk factor for syphilis infection at baseline. At 3 months follow-up, among STI-positive MSM, self-reported anal sex fell from 73.1% to 38.5% (P < 0.001); group sex fell from 19.2% to 5.8% (P < 0.001); and bleeding during anal sex fell from 23.1% to 5.8% (P < 0.001). Among STI-negative MSM, the frequency of one-night stands fell from 32.5% to 17.2% (P < 0.001), and oral sex rose from 57% to 78.5% (P < 0.001). STI-positive MSM were less likely to engage in anal sex compared to STI-negative MSM (χ(2) = 5.189, P = 0.023). HIV testing is an important intervention strategy among MSM. HIV testing services among MSM need to be scaled up, along with comprehensive, tailored interventions including condom promotion and STI treatment.

  10. [Optimisation and establishing of serological methods for the potency testing of immunglobulins against Clostridium tetani-toxin

    PubMed

    Ebert, Elvira; Abu Karim, Annett; Kayser, Tanja; Wenig, Renate; Weibetaer, Karin; Wirz, Maria; Pisani, Giulio; Schäffner, Gabriele; Cubetaler, Klaus

    1998-01-01

    The quality control of human tetanus immunglobulin requires animal experiments according to European Pharmacopoeia monograph 398. The potency estimation has to be done in a toxin neutralisation test in mice (MNT) or guinea pigs. Immunoassays could also be used if they show a suitable sensitivity and specificity. The first results of our study verify that an indirect enzyme linked immunosorbent assay (ELISA), a rocket immunelectrophoresis (RIE) and a toxin binding inhibition test (ToBI) could be used as serological alternativ methods to the MNT. Studies on the reproducibility of the in vitro methods resulted inter-assay coefficients of variation between 2 and 27%. The ELISA is more sensitive (limit of detectability: 0,005 IE/ml) than the ToBI (0,04 IE/ml) and the RIE (5 IE/ml). The transferability of the ELISA to other labs is proofed. The transferability of the RIE and the ToBI will be tested in the near future.

  11. [Update on toxoplasmosis prevalence based on serological tests in pregnant women in Dakar, Senegal from 2002 to 2006].

    PubMed

    Ndiaye, D; Sène, P D; Ndiaye, M; Faye, B; Ndiaye, J L; Ndir, O

    2011-02-01

    The purpose of this study was to update data on toxoplasmosis antibody prevalence based on antenatal surveillance tests in pregnant women in Dakar, Senegal. The study population consisted of 941 pregnant women referred for diagnosis of toxoplasmosis in the Laboratory of Parasitology and Mycology at Le Dantec University Hospital Center from 2002 to 2006. Two tests using the solid-phase immunoenzymatic method were performed on venous blood samples collected at 3 weeks of interval (S1 and S2). This double testing technique was designed to detect increases in IgM and IgG antibody levels in order to confirm diagnosis of toxoplasmosis by ruling out immune response, acquired immunity or nonspecific antibody fixation. Comparison of S1 and S2 results in the 941 patients indicated a prevalence of 7.7% and 0% respectively for IgM+IgG- cases, 23.3% and 24.3% respectively for IgM+IgG-cases, and 11.3% and 10.2% respectively for IgM+IgG+ cases. The overall prevalence of toxoplasmosis antibodies was 34.5%. These data showing a high prevalence of toxoplasmosis among pregnant women in Dakar underscore the need to improve serological screening and follow up.

  12. TestMeEast: a campaign to increase HIV testing in hospitals and to reduce late diagnosis.

    PubMed

    Bath, R; O'Connell, R; Lascar, M; Ferrand, R; Strachan, S; Matin, N; Bassnet, I; Orkin, C

    2016-01-01

    Late diagnosis occurs in almost half of those diagnosed in the UK (HIV Prevention England, 2013. Retrieved June 22, 2014, from HIV Prevention England: http://www.hivpreventionengland.org.uk/Campaigns-Current/National-HIV-Testing-Week ). Testing occurs mainly in sexual health and antenatal clinics despite recommendations to test more broadly [Ellis, S., & Curtis, H. (2012). HIV diagnoses and missed opportunities. Results of the British HIV association (BHIVA) National Audit 2010. Clinical Medicine, 12(5), 430-434]. We report the findings of an HIV-testing week campaign to offer testing to those who have blood tests as part of routine care within outpatient clinics and emergency departments of six London hospitals. The campaign target was to test 500 patients a day during the 2013 National HIV Testing Week (NHTW). Clinic staff and medical students were trained to offer routine HIV testing. Linkage to care was arranged for those who tested HIV-positive. During NHTW we tested 2402 of the planned 2500 test target. 2402/4317 (55.6% 95% CI 54.1-57.1%) of those who had routine blood tests were tested for HIV. There were eight HIV-positive tests; three were new diagnoses (all linked to care). The campaign hashtag #TestMeEast achieved a total Twitter "reach" of 238, 860 and the campaign had widespread news coverage. Our campaign showed that staff and students could be trained and mobilised to do thousands of routine HIV tests during a campaign.

  13. Genital herpes testing among persons living with HIV.

    PubMed

    Mark, Hayley D; Lucea, Marguerite; Nanda, Joy P; Farley, Jason E; Gilbert, Lisa

    2011-01-01

    This cross-sectional survey explored the frequency of genital herpes testing among 110 people living with HIV (PLWH) and reported barriers and facilitators related to testing. Forty-four percent of the respondents had not been tested for genital herpes since receiving an HIV diagnosis, 34% had been tested, and 22% preferred not to say. Respondents' most frequently cited factors affecting a decision to not be tested were: (a) testing not being recommended by a provider, (b) not having herpes symptoms, and (c) not thinking they had herpes. Data from this study indicated that PLWH were not frequently tested for genital herpes; there was a limited understanding of the frequently subclinical nature of infection; and provider recommendations for testing, or lack thereof, affected testing decisions.

  14. Assessment of recent HIV testing among older adults in the United States.

    PubMed

    Guo, Yuqi; Sims, Omar T

    2017-10-01

    Older adults are the fastest growing segment of people living with HIV, and unfortunately many are unaware of their HIV status. Many providers are reluctant to ask older adults about their sexual histories, evaluate their risk factors, and test for HIV, and older adults have low perception of HIV risk. Using data from the 2013 to 2014 National Health and Nutrition Examination Survey, this study assessed the prevalence of recent HIV testing among older adults in the United States (n = 1,056) and identified predictors and barriers to recent HIV testing. The prevalence of recent HIV testing was 28%. Recent HIV testing was associated positively with male gender, education level, having public insurance, having same sex sexual behavior, African, and Hispanic ethnicity, whereas age, income-to-poverty ratio, and Asian ethnicity were associated negatively with recent HIV testing. Public health social workers are advised that targeted HIV testing for Asian, economically disadvantaged, female older adults is needed to increase HIV awareness and detection and to decrease late diagnosis of HIV. Provided public insurance was identified as a predictor of recent HIV testing, facilitating economically disadvantaged older adults' eligibility for public insurance that will likely improve access to HIV testing services and increase HIV testing rates.

  15. HIV (human immunodeficiency virus) testing and prevention in the cruise industry.

    PubMed

    Dahl, Eilif

    2011-01-01

    There are no internationally recognized guidelines regarding HIV for employees on cruise ships. The aim of the study was to survey and compare current practices for crews in the cruise industry regarding HIV testing and prevention. Medical representatives from cruise companies were invited to complete a questionnaire on their company's practices regarding HIV-related issues. Fifteen of 18 invited representatives completed the questionnaire on behalf of 24 companies with a total of 155 ships. All 8 companies with a medical department had a written HIV policy, versus 4 of 16 companies that handled medical crew issues through independent medical consultant services. Thirteen companies required pre-sea HIV testing, 12 had a written HIV policy regarding HIV testing and prevention, and 18 had free condoms for the crew. A positive HIV test would result in revocation of the employment offer from 5 companies and in another 6 companies establish HIV as a pre-existing condition. Eight companies required HIV+ seafarers to demonstrate stability at regular intervals as a condition for sailing. Cruise companies have different practices regarding HIV in crew. Large cruise lines with medical departments are more likely to have a written HIV policy than companies using independent medical consultants. About half the companies required pre-sea HIV testing; some to avoid hiring HIV+ seafarers, others to establish HIV as a pre-existing condition or to ensure proper follow-up of their HIV+ seafarers. This report may provide input for company discussions about present or future HIV policies.

  16. HIV health literacy, sexual behaviour and self-reports of having tested for HIV among students.

    PubMed

    Naidoo, Saloshni; Taylor, Myra

    2015-01-01

    The HIV prevalence among young South African adults makes it important to understand their HIV knowledge, sexual behaviour and HIV counselling and testing (HCT) behaviour in this group. This paper presents the demographics, knowledge, sexual behaviour and cues to action as reported by sexually active students' who had HCT. A cross-sectional study conducted in 10 high schools in the eThekwini and Ugu districts, KwaZulu-Natal, surveyed students' HIV knowledge, sexual behaviour and HCT behaviour. Complete information was available from 1 114 (97.9%) students who participated in the survey. Of these, 378 (33.9%) were sexually active and were included in this analysis. Logistic regression models tested for significant associations between the independent and the dependent variables under study, nesting the students within schools and controlling for age, sex, grade and school location (urban/rural).The median age of students was 17 years (range: 14-23 years) with most being male (n=287; 75.9%). The lifetime median number of sexual partners of students was 3 (range: 1-27). Students who used condoms with their regular partners were more likely to have had counselling for HIV (OR :1.79; 95% CI: 1.06-3.01). Those students who were more likely to have been tested for HIV were female (OR: 44.90; 95% CI: 7.77-259.38), those who had always used a condom with their non-regular partner (OR: 2.75; 95% CI: 1.01-7.47), and those who knew a person who had tested for HIV (OR: 15.28; 95% CI: 5.16-45.23). Targeting students, especially males early in adolescence and reinforcing safe sex behaviour messages through their high school years, can encourage HCT among students.

  17. Serologic tests for detecting antibodies against Mycobacterium bovis and Mycobacterium avium subspecies paratuberculosis in Eurasian wild boar (Sus scrofa scrofa).

    PubMed

    Boadella, Mariana; Lyashchenko, Konstantin; Greenwald, Reena; Esfandiari, Javan; Jaroso, Raquel; Carta, Tania; Garrido, Joseba M; Vicente, Joaquín; de la Fuente, José; Gortázar, Christian

    2011-01-01

    New tools to detect exposure of free-range Eurasian wild boar (Sus scrofa scrofa) to pathogenic mycobacteria would be valuable for improved disease surveillance and wildlife management. Two hundred sera from wild boar of known Mycobacterium bovis infection status were used to evaluate test suitability for the detection of antibodies against M. bovis and Mycobacterium avium subsp. paratuberculosis (or cross-reacting members of the M. avium complex). Two traditional enzyme-linked immunosorbent assays were evaluated using M. bovis purified protein derivative (bPPD) and paratuberculosis protoplasmatic antigen 3 (PPA3) as antigens, respectively, and a new point-of-care test format for bovine tuberculosis (bTB) that uses the innovative dual-path platform (DPP TB) test. The effect of individual factors (sex, age, lesions) on the diagnostic performance of the serologic tests was also determined. Although the DPP had a sensitivity of 89.6% and a specificity of 90.4%, for bPPD, the sensitivity was 79.2% and the specificity 100%. Both tests had a kappa agreement of 0.80. Sixty-five of 68 (95.6%) wild boar sera with antibodies against the PPA3 antigen corresponded to known M. bovis-infected wild boar. Significant differences were not observed in the bPPD and DPP readings among lesion categories or between age classes. A slight sex-related difference in sensitivity toward males in the DPP was found, but it was not detected in the bPPD enzyme-linked immunosorbent assay. The results support the use of antibody-based diagnostic tests for both large-scale and individual bTB testing of Eurasian wild boar and suggest that wild boar cannot be used as sentinels for infections caused by M. avium complex members.

  18. Home Testing Past, Present and Future: Lessons Learned and Implications for HIV Home Tests (A Review)

    PubMed Central

    Ibitoye, Mobolaji; Frasca, Timothy; Giguere, Rebecca; Carballo-Diéguez, Alex

    2014-01-01

    The recent approval in the United States of the first rapid home test to diagnose HIV raises questions about its potential use and impact. We reviewed the existing literature on the unassisted use of home tests involving self-collection and testing of biological samples by untrained users – including existing HIV self-testing studies – to shed some light on what can be expected from the availability of the HIV home test. The studies reviewed showed that most participants could properly perform home tests, obtain accurate results, and interpret them – yielding high correlations with laboratory and health-professional performed tests. Users often had trouble performing blood-based tests. Participants generally understood the need to confirm positive test results. Materials accompanying HIV home tests should emphasize symptoms of acute infection and the need for additional testing when recent infection is suspected. Different home-test-based screening modalities, personalized HIV-counseling resources and HIV home test impact evaluation methods should be studied. PMID:24281697

  19. Impact of a confirmatory RhD test on the correct serologic typing of blood donors

    PubMed Central

    Schmidt, Luciana Cayres; Castilho, Lilian; Vieira, Otavio Vinicius Neves; Sippert, Emília; Gaspardi, Ane Caroline; Martins, Marina Lobato; da Silva Malta, Maria Clara Fernandes

    2015-01-01

    Background The RHD gene is highly polymorphic, which results in a large number of RhD variant phenotypes. Discrepancies in RhD typing are still a problem in blood banks and increase the risk of alloimmunization. In this study, the RhD typing strategy at a blood bank in Brazil was evaluated. Methods One-hundred and fifty-two samples typed as RhD negative and C or E positive by routine tests (automated system and indirect antiglobulin test using the tube technique) were reevaluated for RhD status by three methods. The method with the best performance was implemented and evaluated for a period of one year (n = 4897 samples). Samples that were D positive exclusively in the confirmatory test were submitted to molecular analysis. Results The gel test for indirect antiglobulin testing with anti-D immunoglobulin G (clone ESD1) presented the best results. Seventy samples (1.43%) previously typed as RhD negative showed reactivity in the gel test for indirect antiglobulin testing and were reclassified as D positive. D variants that may cause alloimmunization, such as weak D type 2 and partial DVI, were detected. Conclusion The confirmatory RhD test using the gel test for indirect antiglobulin testing represents a breakthrough in transfusion safety in this blood center. Our results emphasize the importance of assessing the blood group typing strategy in blood banks. PMID:26408363

  20. Evaluation of Kenya's readiness to transition from sentinel surveillance to routine HIV testing for antenatal clinic-based HIV surveillance.

    PubMed

    Sirengo, Martin; Rutherford, George W; Otieno-Nyunya, Boaz; Kellogg, Timothy A; Kimanga, Davies; Muraguri, Nicholas; Umuro, Mamo; Mirjahangir, Joy; Stein, Ellen; Ndisha, Margaret; Kim, Andrea A

    2016-03-05

    Sentinel surveillance for HIV among women attending antenatal clinics using unlinked anonymous testing is a cornerstone of HIV surveillance in sub-Saharan Africa. Increased use of routine antenatal HIV testing allows consideration of using these programmatic data rather than sentinel surveillance data for HIV surveillance. To gauge Kenya's readiness to discontinue sentinel surveillance, we evaluated whether recommended World Health Organization standards were fulfilled by conducting data and administrative reviews of antenatal clinics that offered both routine testing and sentinel surveillance in 2010. The proportion of tests that were HIV-positive among women aged 15-49 years was 6.2% (95% confidence interval [CI] 4.6-7.7%] in sentinel surveillance and 6.5% (95% CI 5.1-8.0%) in routine testing. The agreement of HIV test results between sentinel surveillance and routine testing was 98.0%, but 24.1% of specimens that tested positive in sentinel surveillance were recorded as negative in routine testing. Data completeness was moderate, with HIV test results recorded for 87.8% of women who received routine testing. Additional preparation is required before routine antenatal HIV testing data can supplant sentinel surveillance in Kenya. As the quality of program data has markedly improved since 2010 a repeat evaluation of the use of routine antenatal HIV testing data in lieu of ANC sentinel surveillance is recommended.

  1. Why Take an HIV Test? Concerns, Benefits, and Strategies to Promote HIV Testing among Low-Income Heterosexual African American Young Adults

    ERIC Educational Resources Information Center

    Wallace, Scyatta A.; McLellan-Lemal, Eleanor; Harris, Muriel J.; Townsend, Tiffany G.; Miller, Kim S.

    2011-01-01

    A qualitative study examined perceptions of HIV testing and strategies to enhance HIV testing among HIV-negative African American heterosexual young adults (ages 18-25 years). Twenty-six focus groups (13 male groups, 13 female groups) were conducted in two low-income communities (urban and rural). All sessions were audio-recorded and transcribed.…

  2. Why Take an HIV Test? Concerns, Benefits, and Strategies to Promote HIV Testing among Low-Income Heterosexual African American Young Adults

    ERIC Educational Resources Information Center

    Wallace, Scyatta A.; McLellan-Lemal, Eleanor; Harris, Muriel J.; Townsend, Tiffany G.; Miller, Kim S.

    2011-01-01

    A qualitative study examined perceptions of HIV testing and strategies to enhance HIV testing among HIV-negative African American heterosexual young adults (ages 18-25 years). Twenty-six focus groups (13 male groups, 13 female groups) were conducted in two low-income communities (urban and rural). All sessions were audio-recorded and transcribed.…

  3. Taking HIV Testing to Families: Designing a Family-Based Intervention to Facilitate HIV Testing, Disclosure, and Intergenerational Communication.

    PubMed

    van Rooyen, Heidi; Essack, Zaynab; Rochat, Tamsen; Wight, Daniel; Knight, Lucia; Bland, Ruth; Celum, Connie

    2016-01-01

    Facility-based HIV testing does not capture many adults and children who are at risk of HIV in South Africa. This underscores the need to provide targeted, age-appropriate HIV testing for children, adolescents, and adults who are not accessing health facilities. While home-based counseling and testing has been successfully delivered in multiple settings, it also often fails to engage adolescents. To date, the full potential for testing entire families and linking them to treatment has not been evaluated. The steps to expand a successful home-based counseling and testing model to a family-based counseling and testing approach in a high HIV prevalence context in rural South Africa are described. The primary aim of this family-based model is to increase uptake of HIV testing and linkage to care for all family members, through promoting family cohesion and intergenerational communication, increasing HIV disclosure in the family, and improving antiretroviral treatment uptake, adherence, and retention. We discuss the three-phased research approach that led to the development of the family-based counseling and testing intervention. The family-based intervention is designed with a maximum of five sessions, depending on the configuration of the family (young, mixed, and older families). There is an optional additional session for high-risk or vulnerable family situations. These sessions encourage HIV testing of adults, children, and adolescents and disclosure of HIV status. Families with adolescents receive an intensive training session on intergenerational communication, identified as the key causal pathway to improve testing, linkage to care, disclosure, and reduced stigma for this group. The rationale for the focus on intergenerational communication is described in relation to our formative work as well as previous literature, and potential challenges with pilot testing the intervention are explored. This paper maps the process for adapting a novel and largely successful

  4. HIV-related knowledge, attitudes, perceived benefits, and risks of HIV testing among pregnant women in rural Southern India.

    PubMed

    Rogers, Alexandra; Meundi, Anand; Amma, Ambikadevi; Rao, Aruna; Shetty, Prasanna; Antony, Jubin; Sebastian, Divya; Shetty, Padma; Shetty, Avinash K

    2006-11-01

    The rising prevalence of HIV among pregnant women in rural India is of great concern. Prenatal voluntary counseling and HIV testing (VCT) is critical to prevent mother-to-child transmission of HIV (PMTCT). We surveyed 202 pregnant women attending a rural antenatal clinic in Southern India to investigate HIV-related knowledge, attitudes toward infant feeding practices, and perceived benefits and risks of HIV testing. Of the total of 202 women surveyed, 189 women (94%) had heard of HIV/AIDS and 60% of them had relatively good knowledge regarding risk factors for HIV transmission. However, 48% did not know that there are "means to prevent mother-to-child HIV transmission." If women were not to breastfeed her baby, negative attitudes expected from the partner would include 84% thinking that that the mother is harming the baby, 78% thinking she is not a good mother, 74% thinking she has HIV, and 66% thinking she has been unfaithful. Ninety-seven percent of women did not perceive themselves at risk for HIV and only 57% had been tested for HIV. Although, 85% of women expressed their willingness to be tested, most were concerned about confidentiality and disclosing HIV serostatus because of fear of negative reactions from their husbands, parents, and community. Many social and cultural barriers confront pregnant women when they decide to opt for HIV testing. If VCT and PMTCT interventions are to be successful, urgent attention must be focused on education, development of innovative culturally appropriate interventions that empower women to make decisions about HIV testing, involvement of men, and addressing stigma and discriminatory attitudes toward people living with HIV/AIDS.

  5. HIV testing among pregnant women living with HIV in India: are private healthcare providers routinely violating women's human rights?

    PubMed

    Madhivanan, Purnima; Krupp, Karl; Kulkarni, Vinay; Kulkarni, Sanjeevani; Vaidya, Neha; Shaheen, Reshma; Philpott, Sean; Fisher, Celia

    2014-03-24

    In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India's National AIDS Control Organization. While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings. There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV.

  6. Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations

    PubMed Central

    Hale, Braden R.; Tran, Bonnie R.; Thomas, Anne G.; Grillo, Michael P.; Jacobs, Marni B.; McAnany, Jennifer; Shaffer, Richard A.

    2017-01-01

    HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey. The frequency of individuals who reported they were HIV-positive but subsequently tested HIV-negative using RDT algorithms ranged from 3.3 to 91.1%, suggesting significant rates of prior false-positive HIV RDT algorithm results, which should be confirmed using biological testing across time in future studies. Simple measures could substantially reduce false-positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World Health Organization’s HIV testing guidelines. Other measures to improve RDT algorithm specificity include classifying individuals with weakly positive test lines as HIV indeterminate and retesting. While expansion of HIV testing in resource-limited countries is critical to identifying HIV-infected individuals for appropriate care and treatment, careful attention to potential causes of false HIV-positive results are needed to prevent the significant medical, psychological, and fiscal costs resulting from individuals receiving a false-positive HIV diagnosis. PMID:28686678

  7. Evaluation of allergic and serological tests for diagnosing Brucella melitensis infection in sheep.

    PubMed Central

    Blasco, J M; Marín, C; Jiménez de Bagués, M; Barberán, M; Hernández, A; Molina, L; Velasco, J; Díaz, R; Moriyón, I

    1994-01-01

    A total of 291 unvaccinated sheep from Brucella melitenesis-infected flocks were examined for delayed-type hypersensitivity (DTH) responses with Brucellergene commercial allergen and with cold saline extract and cytosol from rough B. melitensis 115, and their sera were tested in the rose bengal test (RBT), complement fixation test (CFT), and enzyme-linked immunosorbent assay (ELISA) with lipopolysaccharide. DTH reactions were maximal after 72 h, with no intensity differences among allergens, inoculation sites (eyelid and tail), and doses tested. There were no differences in the results recorded by visual inspection and palpation of inoculation sites, by measuring skin thickness with a caliper, or by microscopic examination of samples taken at necropsy. Six days after DTH testing, energy was observed in 100% of the animals, and 100% reactivity was recovered only after 24 days. All animals were necropsied, and thorough bacteriological searches were performed. The sensitivities found with the 140 animals from which B. melitensis was isolated were ELISA, 100%; DTH, 97.1%; RBT, 92.1%; and CFT, 88.6%. Those results put into question the value of RBT and CFT as screening and confirmatory tests for sheep brucellosis and at least indicate that their standardization should be modified. For 151 tested sheep from which B. melitensis was not isolated, the percentages of positive animals were ELISA, 100%; DTH, 94.0%; RBT, 57.6%; and CFT, 53.6%. All tests were negative for 100 tested sheep from Brucella-free flocks. The different results of bacteriological and immunological tests suggest the usefulness of developing indirect tests able to distinguish truly infected animals from those that have developed an immunological response. PMID:7989528

  8. A hybrid mobile HIV testing approach for population-wide HIV testing in rural East Africa: an observational study

    PubMed Central

    Chamie, Gabriel; Clark, Tamara D; Kabami, Jane; Kadede, Kevin; Ssemmondo, Emmanuel; Steinfeld, Rachel; Lavoy, Geoff; Kwarisiima, Dalsone; Sang, Norton; Jain, Vivek; Thirumurthy, Harsha; Liegler, Teri; Balzer, Laura B; Petersen, Maya L; Cohen, Craig R; Bukusi, Elizabeth A; Kamya, Moses R; Havlir, Diane V; Charlebois, Edwin D

    2016-01-01

    Background Despite large investments in HIV testing, only 45% of HIV-infected persons in sub-Saharan Africa are estimated to know their status. Optimal methods for maximizing population-level testing remain unknown. We sought to demonstrate the effectiveness at achieving population-wide testing coverage of a hybrid mobile HIV testing approach. Methods From 2013–2014, we enumerated 168,772 adult (≥15 years) residents of 32 communities in Uganda (N=20), and Kenya (N=12) using a door-to-door census. “Stable” residence was defined as living in community for ≥6 months over the past year. In each community we performed 2-week multi-disease community health campaigns (CHC) that included HIV testing, counseling, and referral to care if HIV-infected; CHC non-participants were approached for home-based testing (HBT) over 1–2 months. We determined population HIV testing coverage, and predictors of testing via HBT (vs. CHC) and non-testing. Findings HIV testing was achieved in 89% of stable adult residents (131,307/146,906). HIV prevalence was 9.6% (13,043/136,033 stable and non-stable adults); median CD4+ T-cell count was 514 cells/μL (IQR: 355–703). Among stable adults tested, 43% (56,106/131,307) reported no prior testing. Among HIV-infected adults, 38% (4,932/13,043) were unaware of their status. Among stable CHC attendees, 99.5% (104,635/105,170) accepted HIV testing. Of stable adults tested, 80% (104,635/131,307, range: 60–93%) tested via CHCs. In multivariable analyses of stable adults, predictors of non-testing included male gender (risk ratio [RR]: 1.52, 95% CI: 1.48–1.56), single marital status (RR: 1.70, 95% CI: 1.66–1.75), Kenyan residence (RR: 1.46, 95% CI: 1.41–1.50, vs. Ugandan), and out-of-community migration for ≥1 month in past year (RR: 1.60, 95% CI: 1.53–1.68). Testing was more common among farmers (RR: 0.73, 95% CI: 0.67–0.79) and adults with primary education (RR: 0.84, 95% CI: 0.80–0.89). Interpretation High HIV testing

  9. Evaluation of hepatitis C, hepatitis B, and HIV virus Serology pandemic in thalassemia patients of Shahid Mohammadi Hospital of Bandar Abbas, Iran.

    PubMed

    Aminianfar, Mohammad; Khani, Farrokh; Ghasemzadeh, Iman

    2017-03-01

    Thalassemia patients are prone to the hepatitis C, B, and HIV virus, due to their constant need to receive blood transfusions. Therefore, this research was aimed to determine the epidemic of the aforementioned diseases in thalassemia patients of Shahid Mohammadi Hospital of Bandar Abbas, Iran. This cross-sectional study was carried out on thalassemia patients visiting the Thalassemia Hospital of Bandar Abbas from March 21, 2014, to March 22, 2015. Checklists were used to collect the data. HBS-Ag, HCV-Ab, and HIV-Ab tests have been registered for hepatitis B, hepatitis C, and HIV virus, respectively. The data were analyzed using SPSS 19 by Mann-Whitney U test, chi-square test, and independent samples t-test. Among 587 records administered into the research, 280 individuals (47.7 %) were men and (52.3 %) were female. The average age of participants was 18.01 ± 9.31 years. The youngest was 1 years old, and the oldest was 46 years old. Four patients under the study (0.7 %) were positive for HBV; 60 (10.2 %) were HCV positive. However, no one in the study was diagnosed HIV positive. In the case of spread, there was no significant difference regarding age and sex in HBV patients. However, in HCV patients, significant differences were found (p=0.044 for gender and p=0.001 for age). In thalassemia, hepatitis C had the highest rate of spread. According to the screening, it was much anticipated that the trend should be falling, but the results show the contrary. Hence, it is recommended that more precise methods such as PCR be used.

  10. Performance of a Rapid Strip Test for the Serologic Diagnosis of Latent Tuberculosis in Children

    PubMed Central

    Thaveekarn, Wichit; Kerdpanich, Phirangkul; Skulpichetrat, Urailak; Saekhow, Orawan; Boonchang, Supatsorn; Bharnthong, Thipchuta; Sitprija, Visith

    2015-01-01

    Background: The serodiagnostic tests for tuberculosis (TB) present a high variability in terms of sensitivity and specificity. Data on patients with latent TB infection (LTBI) and children in high prevalence settings are still limited. The present study aimed to evaluate an in-house strip test for detection of anti-M. tuberculosis antibodies in TB patients, mostly children aged under 15 y, grouped into four diagnostic categories: active TB, LTBI, healthy TB contacts, and other non-TB diseases. Materials and Methods: The diagnostic performance of strip test was compared with the tuberculin skin test (TST) and interferon-gamma release assay (IGRA). Sensitivity and specificity were assessed for all three diagnostic tests. The detection accuracy among the tests was calculated by using a receiver operating characteristic analysis. Results: TST and IGRA could diagnose the active TB cases correctly (100%). The sensitivity of strip test for active TB was 58.3% and 37.5% for LTBI, while the sensitivities of TST and IGRA for LTBI were 90.3% and 37.5%, respectively. The overall specificities of strip test and IGRA were 91.5% and 95.7%, respectively, which were superior to that of TST (68.1%). Conclusion: The strip test did not appear to be useful for diagnosis of active TB in comparison with the current diagnostic standard. The assay may be particularly significant in situations where TB is clinically difficult to diagnose like LTBI and could be a meaningful tool in terms of high specificity and simplicity for ruling in pediatric TB in countries with high TB infection rate. Further studies are needed to determine whether strip test can be improved in its sensitivity and should be implemented into routine clinical practice. PMID:25737986

  11. HIV testing in community pharmacies and retail clinics: a model to expand access to screening for HIV infection.

    PubMed

    Weidle, Paul J; Lecher, Shirley; Botts, Linda W; Jones, LaDawna; Spach, David H; Alvarez, Jorge; Jones, Rhondette; Thomas, Vasavi

    2014-01-01

    To test the feasibility of offering rapid point-of-care human immunodeficiency virus (HIV) testing at community pharmacies and retail clinics. Pilot program to determine how to implement confidential HIV testing services in community pharmacies and retail clinics. 21 community pharmacies and retail clinics serving urban and rural patients in the United States, from August 2011 to July 2013. 106 community pharmacy and retail clinic staff members. A model was developed to implement confidential HIV counseling and testing services using community pharmacy and retail clinic staff as certified testing providers, or through collaborations with organizations that provide HIV testing. Training materials were developed and sites selected that serve patients from urban and rural areas to pilot test the model. Each site established a relationship with its local health department for HIV testing policies, developed referral lists for confirmatory HIV testing/care, secured a CLIA Certificate of Waiver, and advertised the service. Staff were trained to perform a rapid point-of-care HIV test on oral fluid, and provide patients with confidential test results and information on HIV. Patients with a preliminary positive result were referred to a physician or health department for confirmatory testing and, if needed, HIV clinical care. Number of HIV tests completed and amount of time required to conduct testing. The 21 participating sites administered 1,540 HIV tests, with 1,087 conducted onsite by staff during regular working hours and 453 conducted at 37 different HIV testing events (e.g., local health fairs). The median amount of time required for pretest counseling/consent, waiting for test results, and posttest counseling was 4, 23, and 3 minutes, respectively. A majority of the sites (17) said they planned to continue HIV testing after the project period ended and would seek assistance or support from the local health department, a community-based organization, or an AIDS

  12. HIV testing in community pharmacies and retail clinics: A model to expand access to screening for HIV infection

    PubMed Central

    Weidle, Paul J.; Lecher, Shirley; Botts, Linda W.; Jones, LaDawna; Spach, David H.; Alvarez, Jorge; Jones, Rhondette; Thomas, Vasavi

    2015-01-01

    Objective To test the feasibility of offering rapid, point-of-care human immunodeficiency virus (HIV) testing at community pharmacies and retail clinics. Design Pilot program to determine how to implement confidential HIV testing services in community pharmacies and retail clinics. Setting 21 community pharmacies and retail clinics serving urban and rural patients in the United States, from August 2011 to July 2013. Participants 106 community pharmacy and retail clinic staff members. Intervention A model was developed to implement confidential HIV counseling and testing services using community pharmacy and retail clinic staff as certified testing providers, or through collaborations with organizations that provide HIV testing. Training materials were developed and sites selected that serve patients from urban and rural areas to pilot test the model. Each site established a relationship with its local health department for HIV testing policies, developed referral lists for confirmatory HIV testing/care, secured a CLIA Certificate of Waiver, and advertised the service. Staff were trained to perform a rapid point-of-care HIV test on oral fluid, and provide patients with confidential test results and information on HIV. Patients with a preliminary positive result were referred to a physician or health department for confirmatory testing and, if needed, HIV clinical care. Main outcome measures Number of HIV tests completed and amount of time required to conduct testing. Results The 21 participating sites administered 1,540 HIV tests, with 1,087 conducted onsite by staff during regular working hours and 453 conducted at 37 different HIV testing events (e.g., local health fairs). The median amount of time required for pretest counseling/consent, waiting for test results, and posttest counseling was 4, 23, and 3 minutes, respectively. A majority of the sites (17) said they planned to continue HIV testing after the project period ended and would seek assistance or support

  13. HIV/AIDS stigma and refusal of HIV testing among pregnant women in rural Kenya: results from the MAMAS Study.

    PubMed

    Turan, Janet M; Bukusi, Elizabeth A; Onono, Maricianah; Holzemer, William L; Miller, Suellen; Cohen, Craig R

    2011-08-01

    HIV/AIDS stigma is a common thread in the narratives of pregnant women affected by HIV/AIDS globally and may be associated with refusal of HIV testing. We conducted a cross-sectional study of women attending antenatal clinics in Kenya (N = 1525). Women completed an interview with measures of HIV/AIDS stigma and subsequently information on their acceptance of HIV testing was obtained from medical records. Associations of stigma measures with HIV testing refusal were examined using multivariate logistic regression. Rates of anticipated HIV/AIDS stigma were high-32% anticipated break-up of their relationship, and 45% anticipated losing their friends. Women who anticipated male partner stigma were more than twice as likely to refuse HIV testing, after adjusting for other individual-level predictors (OR = 2.10, 95% CI: 1.15-3.85). This study demonstrated quantitatively that anticipations of HIV/AIDS stigma can be barriers to acceptance of HIV testing by pregnant women and highlights the need to develop interventions that address pregnant women's fears of HIV/AIDS stigma and violence from male partners.

  14. Preliminary study of an immunochromatography test for serological diagnosis of canine brucellosis.

    PubMed

    Wanke, M M; Cairó, F; Rossano, M; Laiño, M; Baldi, P C; Monachesi, N E; Comercio, E A; Vivot, M M

    2012-12-01

    The most widely used screening test for the diagnosis of brucellosis in the dog is the rapid slide agglutination test in the presence of 2-mercaptoethanol (2ME-RSAT). The diagnosis is partially confirmed by the agar gel immunodiffusion test (AGID) and definitively confirmed by bacteriological isolation. Some chronic cases not detected by these tests may be detected by ELISA tests. The use of 2ME-RSAT in routine clinical practice requires a microscope and an experienced operator. An immunochromatographic diagnostic test for canine brucellosis (FASTest(®) Brucella c., Megacor, Hörbranz, Austria) has been recently released. In this study, we compared the diagnostic performance of the FASTest with those of 2ME-RSAT, AGID and ELISAs. Sera from 17 healthy dogs used as negative controls yielded negative results by FASTest, indicating a 100% specificity in this sample. Among 27 sera of dogs with acute or subacute brucellosis confirmed by B. canis isolation, all of which were positive by RSAT and ELISAs, the FASTest was positive in 24 cases and AGID in 23. In acute and subacute cases, the sensitivity of FASTest was 89%. Sera from six dogs with bacteriologically confirmed chronic brucellosis, which were positive by ELISAs but negative by 2ME-RSAT, were also tested; 1 was positive by FASTest and 4 were positive by AGID. These preliminary results indicate a good specificity of the FASTest (100% in this sample) but an unacceptable sensitivity as a screening test. In cases with chronic brucellosis, the sensitivity of the FASTest was lower than that of ELISAs but this assay could make a good intermediate test to be run after a positive RSAT and before running an AGID.

  15. Analysis of theory utilization among prenatal HIV-testing research.

    PubMed

    Delissaint, Dieula; McKyer, E Lisako J

    2008-01-01

    To ascertain extent and quality of theory utilization among published empirical studies specific to prenatal HIV testing. Systematic literature search for peer-reviewed articles was performed. Articles with "perceived barriers" construct to prenatal HIV testing from perspective of potential testees were sought. Most studies mention constructs, but not specific theory. Few studies clearly reported how operationalized constructs were used within their studies. Paucity of theory utilization points to a breach of the "science" in the scientific process. Researchers either failed to adequately use theory or did so but failed to describe how.

  16. Impact on HIV test providers of giving a positive test result.

    PubMed

    Myers, Ted; Worthington, Catherine; Aguinaldo, Jeffrey P; Haubrich, Dennis J; Ryder, Karen; Rawson, Brian

    2007-09-01

    The provision of a positive HIV antibody test result and the direction and support given to the test recipient are critical components of care and prevention. There has been little research that describes what happens in such interactions between recipient and provider. The impact on the test provider of delivering the HIV test result is an important issue to consider. The discomfort experienced by some health providers in giving a positive test result may have adverse effects on the client interaction or may carry over into subsequent client interactions. Utilizing a thematic analysis on interview data from 24 HIV test providers, we describe the impact of delivering a positive test result on HIV test providers, identify the factors that influence this impact, and describe strategies used to manage the impact. As with other health care professionals communicating "bad news,"HIV test providers experience a variety of impacts. While a small number of providers indicated little or no impact of delivering the HIV positive test result because the diagnosis is ''not the end of the world,'' most indicated it was difficult as it was anticipated that the test recipient would (or did) find the news distressing. Several coping strategies were identified.

  17. Discordant rapid HIV tests: lessons from a low-resource community.

    PubMed

    Adetunji, A A; Kuti, M A; Audu, R A; Muyibi, S A; Imhansoloeva, M; Mosuro, O A; Solanke, E A; Akpa, O M; Irabor, A E; Ladipo, Mma; Berzins, B; Robertson, K; Ogunniyi, A; Adewole, I F; Taiwo, B O

    2017-07-31

    HIV rapid antibody tests are widely used in Africa, but dual testing sometimes produces discordant results. It is not clear if discordant rapid HIV tests should always heighten suspicion by frontline health workers that early HIV infection is present. Some studies have reported that discordant rapid tests have value for identifying early HIV infection in high HIV prevalence populations. It is not known if rapid test performance influenced this conclusion, or if this observation will hold true for low HIV prevalence populations. We therefore explored the occurrence of discordant rapid HIV tests in a low-resource community. A cross-sectional sample of HIV status-unaware adults with recent exposure to unsafe sex was assessed using a validated risk-based tool (University of North Carolina (UNC)-Malawi Risk Screening Score) for acute HIV infection. Participants received rapid testing with Determine™ HIV 1/2 and Uni-Gold™ HIV assays, plus plasma HIV-1 antigen testing with the COBAS(®) Ampliprep/COBAS(®) Taqman(®) HIV-1 assay, followed by western blot in those with detected HIV-1 antigen. Of 408 participants, 1.0% were confirmed to have established HIV infection. The discordance between rapid tests at initial screening was 2.45 and 2.94% when the two assays were used sequentially and simultaneously, respectively. Discordant rapid tests were strongly associated with risk scores > 2 [odds ratio (OR) 10.88; 95% confidence interval (CI) 2.35-50.43], and with detected HIV-1 RNA (OR 26.06; 95% CI 3.91-173.60). When the sample occurrence of discordance between the first and second tests is below 5%, discordant rapid tests in an adult with sexual risk behaviour should trigger strong suspicion of early HIV infection in low HIV prevalence populations. © 2017 British HIV Association.

  18. Socio-demographic inequalities in HIV testing behaviour and HIV prevalence among older adults in rural Tanzania, 2013.

    PubMed

    Mtowa, Angelina; Gerritsen, Annette A M; Mtenga, Sally; Mwangome, Mary; Geubbels, Eveline

    2017-09-01

    Most HIV research in Sub-Saharan Africa (SSA) ignores persons aged 50 years and above, though a few studies have reported a high HIV prevalence among older people. This study aimed to estimate socio-demographic inequalities in HIV testing behaviour and HIV prevalence among adults aged 50+ years, living in Ifakara town, Tanzania. This cross-sectional study used data from the baseline measurement of the Ifakara MZIMA cohort study in 2012/13. Consenting participants were interviewed and tested for HIV. Associations between HIV testing behaviour and HIV prevalence with socio-demographic indicators were explored with multivariable logistic regression. Among the 1643 adults 50+ years included in the study, HIV prevalence and the HIV testing rate (ever tested) were 6% and 11.4% respectively. The HIV testing rate was lower for older people (aOR = 0.19 (95% CI 0.09-0.41 for 75+ versus 50-54 years); higher for those separated/divorced/widowed than those married (aOR = 1.46; 1.02-2.10); higher for "other Christians" than Muslims (aOR = 1.95; 1.06-3.58); and higher for primary (aOR = 1.54; 1.01-2.33) and secondary (aOR = 3.47; 2.11-5.70) school graduates than those without education. HIV prevalence was lower for older people (aOR = 0.27; 0.11-0.66 for 75+ versus 50-54); and for Catholics compared to Muslims (aOR = 0.54; 0.34-0.85). The high HIV prevalence among older adults and the low HIV testing behaviour call for more efforts on HIV prevention, treatment and care.

  19. Proximate context of HIV stigma and its association with HIV testing in Sierra Leone: a population-based study

    PubMed Central

    KELLY, J. Daniel; WEISER, Sheri D.; TSAI, Alexander C.

    2015-01-01

    The extent to which HIV stigma at the community level remains a barrier to greater uptake is poorly understood. We used nationally representative data from the 2008 Sierra Leone Demographic and Health Survey. The primary outcome was HIV testing (past 12 months). Our explanatory variable was HIV stigmatizing attitudes (5-item scale). After multivariable adjustment, HIV testing had an inverse association with HIV stigmatizing attitudes measured at the individual (adjusted odds ratio [AOR]=0.94; 95% CI, 0.87–1.01) and community level (AOR=0.70; 95% CI, 0.58–0.85). HIV stigma had a stronger negative association with HIV testing when modeled at the community rather than individual level. PMID:25771909

  20. Structural inequalities drive late HIV diagnosis: The role of black racial concentration, income inequality, socioeconomic deprivation, and HIV testing.

    PubMed

    Ransome, Yusuf; Kawachi, Ichiro; Braunstein, Sarah; Nash, Denis

    2016-11-01

    In the United States, research is limited on the mechanisms that link socioeconomic and structural factors to HIV diagnosis outcomes. We tested whether neighborhood income inequality, socioeconomic deprivation, and black racial concentration were associated with gender-specific rates of HIV in the advanced stages of AIDS (i.e., late HIV diagnosis). We then examined whether HIV testing prevalence and accessibility mediated any of the associations above. Neighborhoods with highest (relative to lowest) black racial concentration had higher relative risk of late HIV diagnosis among men (RR=1.86; 95%CI=1.15, 3.00) and women (RR=5.37; 95%CI=3.16, 10.43) independent of income inequality and socioeconomic deprivation. HIV testing prevalence and accessibility did not significantly mediate the associations above. Research should focus on mechanisms that link black racial concentration to HIV diagnosis outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. HIV RNA testing in the context of nonoccupational postexposure prophylaxis.

    PubMed

    Roland, Michelle E; Elbeik, Tarek A; Kahn, James O; Bamberger, Joshua D; Coates, Thomas J; Krone, Melissa R; Katz, Mitchell H; Busch, Michael P; Martin, Jeffrey N

    2004-08-01

    The specificity and positive predictive value of human immunodeficiency virus (HIV) RNA assays have not been evaluated in the setting of postexposure prophylaxis (PEP). Plasma from subjects enrolled in a nonoccupational PEP study was tested with 2 branched-chain DNA (bDNA) assays, 2 polymerase chain reaction (PCR) assays, and a transcription-mediated amplification (TMA) assay. Assay specificity and positive predictive value were determined for subjects who remained negative for HIV antibody for >or=3 months. In 329 subjects examined, the lowest specificities (90.1%-93.7%) were seen for bDNA testing performed in real time. The highest specificities were seen with batched bDNA version 3.0 (99.1%), standard PCR (99.4%), ultrasensitive PCR (100%), and TMA (99.6%) testing. Only the 2 assays with the highest specificities had positive predictive values >40%. For the bDNA assays, increasing the cutoff point at which a test is called positive (e.g., from 50 copies/mL to 500 copies/mL for version 3.0) increased both specificity and positive predictive values to 100%. The positive predictive value of HIV RNA assays in individuals presenting for PEP is unacceptably low for bDNA-based testing and possibly acceptable for PCR- and TMA-based testing. Routine use of HIV RNA assays in such individuals is not recommended.

  2. A rapid ultrasound particle agglutination method for HIV antibody detection: Comparison with conventional rapid HIV tests.

    PubMed

    Bystryak, Simon; Ossina, Natalya

    2017-08-24

    We present the results of the feasibility and preliminary studies on analytical performance of a rapid test for detection of human immunodeficiency virus (HIV) antibodies in human serum or plasma that is an important advance in detecting HIV infection. Current methods for rapid testing of antibodies against HIV are qualitative and exhibit poor sensitivity (limit of detection). In this paper, we describe an ultrasound particle agglutination (UPA) method that leads to a significant increase of the sensitivity of conventional latex agglutination tests for HIV antibody detection in human serum or plasma. The UPA method is based on the use of: 1) a dual mode ultrasound, wherein a first single-frequency mode is used to accelerate the latex agglutination process, and then a second swept-frequency mode of sonication is used to disintegrate non-specifically bound aggregates; and 2) a numerical assessment of results of the agglutination process. The numerical assessment is carried out by optical detection and analysis of moving patterns in the resonator cell during the swept-frequency mode. The single-step UPA method is rapid and more sensitive than the three commercial rapid HIV test kits analyzed in the study: analytical sensitivity of the new UPA method was found to be 510-, 115-, and 80-fold higher than that for Capillus™, Multispot™ and Uni-Gold™ Recombigen HIV antibody rapid test kits, respectively. The newly developed UPA method opens up additional possibilities for detection of a number of clinically significant markers in point-of-care settings. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Relationship between Human Immunodeficiency Virus (HIV) Knowledge, HIV-Related Stigma, and HIV Testing among Young Black Adults in a Southeastern City

    PubMed Central

    Okumu, Eunice; Jolly, David H.; Alston, Le’Marus; Eley, Natalie T.; Laws, Michelle; MacQueen, Kathleen M.

    2017-01-01

    The southeast is identified as the epicenter of the nation’s human immunodeficiency virus (HIV) epidemic, accounting for nearly 44% of all persons living with a HIV diagnosis in the United States. HIV stigma and knowledge have been cited as some of the complex factors increasing risk of acquiring HIV within African-American communities. We sought to understand how HIV knowledge and HIV-related stigma impact HIV testing experience among young Black adults who completed a community-based participatory research survey in a Southeastern city. Survey measures were developed with active engagement among the research team and community members, with the goal of balancing community knowledge, interests and concerns with scientific considerations, and the realities of funding and the project timeline. A total of 508 of the 513 audio computer-assisted self-interview questionnaires completed were analyzed. Eighty-one percent of participants had ever tested and had an intention-to-test for HIV in the next 12 months. Overall, analyses revealed low HIV-related stigma and relatively moderate to high HIV knowledge among young Black adults in the Southeastern city. Logistic regression indicated that having ever tested for HIV was positively correlated with HIV knowledge [odds ratio (OR): 1.50; 95% confidence interval (CI): 1.23–1.84, p < 0.001], but inversely correlated with low HIV-related stigma (OR: 0.08; 95% CI: 0.01–0.76, p < 0.03). However, there were no significant relationships between HIV-related stigma, HIV knowledge, and intention-to test for HIV in the future. These findings suggest that reducing HIV-related stigma and increasing HIV knowledge are not sufficient in promoting HIV testing (i.e., intention-to-test) among young Black adults in this city, unless specific emphasis is placed on addressing internalized HIV-related stigma and misperceptions about HIV prevention and control. PMID:28349049

  4. FACTORS RELATED TO HIV TESTING AMONG AN AFRICAN AMERICAN CHURCH-AFFILIATED POPULATION

    PubMed Central

    Berkley-Patton, Jannette; Moore, Erin W.; Hawes, Starlyn M.; Thompson, Carole Bowe; Bohn, Alexandria

    2014-01-01

    HIV continues to disproportionately impact communities of color, and more calls are being extended to African American churches to assist in HIV education and screening efforts. However, no studies have reported on the HIV testing practices of African American church-affiliated persons. This study examines demographic, social, and behavioral factors associated with ever receiving an HIV test and last 12-month HIV testing. Findings indicated not having insurance and condom use were predictors of ever receiving an HIV test. Predictors of HIV testing in the last 12 months included marital status (i.e., single, divorced, separated, or widowed) and intentions to get tested for HIV in the near future. These predictors should be considered when designing HIV education and screening interventions for African American church settings. PMID:22468975

  5. Use of Tunable, Pulsed Dye Laser for Quantitative Fluorescence in Syphilis Serology (FTA-ABS Test)

    PubMed Central

    Kasatiya, S. S.; Lambert, N. G.; Laurence, R. A.

    1974-01-01

    A pulsed dye laser was used as an excitation source in a fluorescent treponemal antibody absorption (FTA-ABS) test. A high precision in quantitative fluorescence was obtained with this high-power excitation source coupled to an electronic detection system and a storage oscilloscope by standardization of fluorescence evaluation and through elimination of human error. One 0.4-μs pulse exposure was sufficient to record fluorescence intensity data on the oscilloscope. Absence of fading of fluorescence after repeated excitation permitted multiple readings of the same microscope field. Almost 100% reproducible results were obtained for the FTA-ABS test with 40 samples. Electronic detection of fluorescence and the high sensitivity obtained with laser excitation raise doubts about the relative value of quantitative immunofluorescence in the FTA-ABS test. PMID:4598221

  6. Toward universal access to HIV counseling and testing and antiretroviral treatment in Ethiopia: looking beyond HIV testing and ART initiation.

    PubMed

    Assefa, Yibeltal; Van Damme, Wim; Mariam, Damen Haile; Kloos, Helmut

    2010-08-01

    Expanding access to HIV counseling and testing (HCT) and antiretroviral treatment (ART) has reduced morbidity and mortality in people living with HIV/AIDS. As a result, many countries are scaling up HIV/AIDS services. In this paper we discuss challenges experienced during the move toward universal access to HCT and ART services in Ethiopia. We reviewed routine reports from the Ministry of Health and implementing partners. We also had interviews, about linkage to and retention in care of patients, with 10 HIV/AIDS program managers, as well as 2 to 7 health care providers and 5 to 15 patients in each of 23 health centers and 32 hospitals in all regions of the country. We found that the number of people tested for HIV increased 10-fold from 435,854 in 2005 to 4,559,954 in 2008. Only 61% of the HIV-positive patients were linked to chronic care immediately after tested for HIV. The number of patients initiated on ART annually increased from 26,021 in 2005 to 53,696 in 2008. Attrition of patients increased from 18% in 2005 to 26% in 2008. Our interviews indicated that fear of stigma, transport cost, feeling healthy and opting for traditional medicines were the main reasons for poor linkage to and retention in care. Lack of nutrition and feeling better were also reasons for poor retention. In conclusion, in spite of the rapid scale-up of HCT and ART services in Ethiopia, linkage and retention were not adequate. Therefore, strategies should be developed and implemented to improve linkage and retention.

  7. Serolo