ArticleJournal of clinical virology : the official publication of the Pan American Society for Clinical Virology2017
Real-world performance of the new US HIV testing algorithm in medical settings.
Article in Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 16 citations in OpenAlex.
- Challenges in HIV Diagnosis Algorithm: Experience of the Confirmation Laboratory.Journal of tropical medicine · 2025Article
- Missed and Delayed Diagnoses of Acute Human Immunodeficiency Virus (HIV) Infection in a Southern Opt-Out HIV Testing Environment Without Reflex HIV RNA Testing.Open forum infectious diseases · 2025Article
- Evaluation of the MAGLUMI HIV Ab/Ag combi test for the detection of HIV infection.Virology journal · 2024Article
- Review of HIV Self Testing Technologies and Promising Approaches for the Next Generation.Biosensors · 2023Review
- Article
- Performance of an Alternative Laboratory-Based HIV Diagnostic Testing Algorithm Using HIV-1 RNA Viral Load.Sexually transmitted diseases · 2020Article
- Risks of requiring a dedicated molecular specimen for HIV diagnosis and a potential strategy for mitigation.PloS one · 2020Article
- Performance of the Alere Determine™ HIV-1/2 Ag/Ab Combo Rapid Test with algorithm-defined acute HIV-1 infection specimens.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2018Article
- Trends in testing algorithms used to diagnose HIV infection, 2011-2015, United States and 6 dependent areas.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2018Article
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundOur medical center laboratory recently adapted its 24/7, two-hourly testing program to use an ARCHITECT-Multispot-viral load (AR-MS-VL) algorithm in place of a previous rapid test-immunofluorescence (RT-IF) algorithm.
objectivesWe evaluated screening test performance, acute case detection, turnaround time and ability to resolve HIV status under the new algorithm. STUDY
designWe considered consecutive HIV tests from January to November 2015. AR-MS-VL results at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) were compared with RT-IF results at ZSFG and also with AR-MS-VL results in the recently completed CDC Screening Targeted Populations to Interrupt On-going Chains of HIV Transmission with Enhanced Partner Notification (STOP) Study for targeted testing of MSM at publicly funded testing sites in San Francisco.
resultsAmong 21,985 HIV tests performed at ZSFG, 16,467 were tested by RT-IF and 5518 by AR-MS-VL. There were 321 HIV infections detected, of which 274 (84%) were known HIV+ cases, and 47 were newly identified HIV infections. Considering only patients of HIV-negative or -unknown status, prevalence was 0.22%. Under the AR-MS-VL algorithm, turnaround times for screening results and full algorithm results were 3 and 21h; status-unresolved cases were reduced (from 47% to 22%) compared with the RT-IF algorithm. The positive predictive value (PPV) of a new-positive AR screening test was low (0.44) at ZSFG, where no acute infections were detected. At STOP Study sites where HIV prevalence was higher and acute infection was more common, the AR PPV was higher (0.93). All 24 false-positive AR screening tests at ZSFG had a signal/cutoff (S/CO) ratio of <15 and all 88 true-positive tests had S/CO ratio >15. Of 62 acute infections in the STOP Study, 23 (37%) had an S/CO<15. DISCUSSION: An AR-MS-VL algorithm is feasible and can return rapid results in a large medical center. In this setting, reactive 4th generation assay tests that are negative for HIV antibodies are typically false-positive with low S/CO ratios.
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