Evidence map›Paper›PMID 28758335›Full record

ArticleHIV medicine2018

Discordant rapid HIV tests: lessons from a low-resource community.

A A Adetunji, M A Kuti, R A Audu, S A Muyibi, M Imhansoloeva, O A Mosuro, E A Solanke, O M Akpa, A E Irabor, Mma Ladipo and 5 more

Abstract read
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In one paragraph

Article in HIV medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

A A AdetunjiDepartment of Family Medicine, University College Hospital, Ibadan, Nigeria.ORCID 0000-0003-1589-6228
M A KutiDepartment of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
R A AuduHuman Virology Laboratory, Nigerian Institute of Medical Research, Lagos, Nigeria.
S A MuyibiDepartment of Family Medicine, University College Hospital, Ibadan, Nigeria.
M ImhansoloevaDepartment of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.
O A MosuroDepartment of Family Medicine, University College Hospital, Ibadan, Nigeria.
E A SolankeDepartment of Family Medicine, University College Hospital, Ibadan, Nigeria.
O M AkpaDepartment of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.
A E IraborDepartment of Family Medicine, University College Hospital, Ibadan, Nigeria.
Mma LadipoDepartment of Family Medicine, University College Hospital, Ibadan, Nigeria.
B BerzinsDivision of Infectious Diseases, Center for Global Health, Northwestern University, Chicago, IL, USA.
K RobertsonDepartment of Neurology, University of North Carolina, Chapel Hill, NC, USA.
A OgunniyiDepartment of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.
I F AdewoleDepartment of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria.
B O TaiwoDivision of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Funding

Multidisciplinary NeuroAIDS Research Training to Improve HIV Outcomes in NigeriaD43TW009608 · FIC · NORTHWESTERN UNIVERSITY AT CHICAGO · PI PHILIP B GORELICK, Olayinka Olusola Omigbodun · 2013 to 2026
$3.9M
FIC NIH HHS D43 TW009608
6 · The paper itself

Abstract

objectivesHIV 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.

methodsA 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

resultsOf 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).

conclusionsWhen 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.

Indexed as

AdolescentAdultAgedAged, 80 and overCross-Sectional StudiesDiagnostic Tests, RoutineFemaleHIV-1HIV AntibodiesHIV AntigensHIV InfectionsHumansImmunoassayMalawiMaleMiddle AgedHIV AntibodiesHIV Antigensacute HIV infectionAfricadiscordant rapid testsearly HIV infectionHIVHIV antibody testrapid HIV test

Identifiers

PMID28758335
PMCPMC5807078

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.