Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-25T04:20:43.790Z Has data issue: false hasContentIssue false
  • English
  • Français

Low Rate of False-Positive Results with Use of A Rapid HIV Test

Published online by Cambridge University Press:  02 January 2015

Cassandra D. Salgado ,
Heidi L. Flanagan ,
Doris M. Haverstick  and
Barry M. Farr
Cassandra D. Salgado
Affiliation:
Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
Heidi L. Flanagan
Affiliation:
Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
Doris M. Haverstick
Affiliation:
Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
Barry M. Farr*
Affiliation:
Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
*
Box 800473 Cobb Hall, University of Virginia Health System, Charlottesville, VA 22908
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Occupational exposure to human immunodeficiency virus (HIV) is an important threat to healthcare workers. Centers for Disease Control and Prevention guidelines recommend prompt institution of prophylaxis. This requires (1) immediate prophylaxis after exposure, pending test results that may take more than 24 hours in many hospitals; or (2) performance of a rapid test. The Single Use Diagnostic System (SUDS)® HIV-1 Test is used to screen rapidly for antibodies to HIV type 1 in plasma or serum, with a reported sensitivity of more than 99.9%. We used this test from January 1999 until September 2000, when it was withdrawn from the market following reports claiming a high rate of false-positive results.

Methods:

We reviewed the results of postexposure HIV testing during 21 months.

Results:

A total of 884 SUDS tests were performed on source patients after occupational exposures (883 negative results, 1 reactive result). The results of repeat SUDS testing on the reactive specimen were also reactive, but the results of enzyme immunoassay and Western blot testing were negative. A new specimen from the same patient showed a negative result on SUDS testing. This suggested a specificity of 99.9%. In the 4 months after SUDS testing was suspended, there was 1 false-positive result on enzyme immunoassay for 1 of 132 source patients (presumed specificity, 99.2%).

Conclusion:

Use of the SUDS test facilitated rapid and accurate evaluation of source specimens, obviating unnecessary prophylaxis.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 6 , June 2002 , pp. 335 - 337
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.UNAIDS and Joint United Nations Programme on HIV/AIDS. AIDS epidemic update: December 2000. Geneva: World Health Organization; 2002. Available at www.unaids.org.Google Scholar
2.Centers for Disease Control and Prevention. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR 2001;50:1–42.Google Scholar
3.Centers for Disease Control and Prevention. Preventing Occupational HIV Transmission to Healthcare Personnel. Atlanta, GA: Centers for Disease Control and Prevention; 2002. Available at www.cdc.gov/hiv/pubs/facts/hcwprev.Google Scholar
4.Niu, M, Stein, D, Schnittman, S. Primary human immunodeficiency virus type 1 infection: review of pathogenesis and early treatment intervention in humans and animal retrovirus infections. J Infect Dis 1993;168:490–501.Google ScholarPubMed
5.Shih, C, Kaneshima, H, Rabin, L, et al. Postexposure prophylaxis with zidovudine suppresses human immunodeficiency virus type 1 infection in SCID-hu mice in a time-dependent manner. J Infect Dis 1991;163:625–627.Google Scholar
6.Tokars, J, Marcus, R, Culver, D, et al. Surveillance of HIV infection and zidovudine use among healthcare workers after occupational exposure to HIV-infected blood: The CDC Cooperative Needlestick Surveillance Group. Ann Intern Med 1993;118:913–919.Google Scholar
7.Pinkerton, S, Holtgrave, D, Pinkerton, H. Cost-effectiveness of chemoprophylaxis after occupational exposure to HIV. Arch Intern Med 1997; 157:1972–1980.Google Scholar
8.Kassler, W, Haley, C, Jones, W, Gerber, A, Kennedy, E, George, J. Performance of a rapid, on-site human immunodeficiency virus antibody assay in a public health setting. J Clin Microbiol 1995;33:2899–2902.Google Scholar
9.Malone, J, Smith, E, Sheffield, J, et al. Comparative evaluation of six rapid serological tests for HIV-1 antibody. J Acquir Immune Defic Syndr 1993; 6:115–119.Google Scholar
10.Shelton, DL. New York state physicians slam rapid perinatal HIV test. American Medical News March 13, 2000. Available at www.amednews.com.Google Scholar
11.MacDonald, K, Jackson, B, Bowman, R, et al. Performance characteristics of serologic tests for human immunodeficiency virus type 1 (HIV-1) antibody among Minnesota blood donors. Ann Intern Med 1989;110:617–621.CrossRefGoogle ScholarPubMed
12.Wang, S, Panlilio, A, Doi, P, White, A, Stek, M, Saah, A. Experience of healthcare workers taking postexposure prophylaxis after occupational HIV exposures: findings of the HIV Postexposure Prophylaxis Registry. Infect Control Hosp Epidemiol 2000;21:780–785.Google Scholar
13.Centers for Disease Control and Prevention. Serious adverse events attributed to nevirapine regimens for postexposure prophylaxis after HIV exposures: worldwide, 1997-2000. MMWR 2001;49:1153–1156.Google Scholar
14.Trape, M, Barnosky, S. Nelfinavir in expanded postexposure prophylaxis causing acute hepatitis with cholestatic features: two case reports. Infect Control Hosp Epidemiol 2001;22:333–334.Google Scholar
15.Kallenborn, J, Price, T, Carrico, , Davidson, A. Emergency department management of occupational exposures: cost analysis of rapid HIV test. Infect Control Hosp Epidemiol 2001;22:289–293.Google Scholar