ArticleFrontiers in public health2025
Rapid diagnosis of acute HIV-1 infection cases: first real-world performance of point-of-care HIV-1 nucleic acid testing in China.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Timely diagnosis of acute HIV infection (AHI) is critical for curbing transmission. However, the diagnostic window prior to antibody development limits the utility of conventional serological assays. Conventional laboratory-based nucleic acid testing (LABT) is often hindered by operational complexity and long turnaround times. Point-of-care nucleic acid testing (POCT) provides a rapid alternative. Methods: This multicenter cross-sectional study enrolled 1,829 adults from 13 cities in Jiangsu Province and Kunming, Yunnan Province, who had reactive screening results but negative or indeterminate Western blot outcomes. The diagnostic accuracy, quantitative correlation, and agreement of the POCT (Xpert® HIV-1 Viral Load point-of-care test) were compared with LABT using the Roche COBAS TaqMan v2.0 or Abbott RealTime HIV-1 assays, with follow-up seroconversion serving as the reference standard. Turnaround time from initial screening to NAT result reporting was compared using Kaplan-Meier analysis. Laboratory staff perceptions of POCT usability were evaluated via questionnaire. Results: Using follow-up seroconversion as a reference, POCT demonstrated a sensitivity of 98.87% and specificity of 100.00%, with almost perfect agreement with LABT (99.76%, Cohen's Conclusion: The Xpert HIV-1 POCT provides a highly accurate and rapid alternative to LABT for diagnosing AHI in China. Its implementation can dramatically shorten diagnostic delays, potentially reducing loss to follow-up and onward transmission, thus offering significant value within the national HIV diagnostic framework.
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