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Low specificities of HIV diagnostic tests caused by Trypanosoma brucei gambiense sleeping sickness

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dc.contributor.author Lejon, V.
dc.contributor.author Mumba Ngoyi, D.
dc.contributor.author Ilunga, M.
dc.contributor.author Beelaert, G.
dc.contributor.author Maes, I.
dc.contributor.author Büscher, P.
dc.contributor.author Fransen, K.
dc.date.accessioned 2010-08-18T09:32:14Z
dc.date.available 2010-08-18T09:32:14Z
dc.date.issued 2010
dc.identifier.issn 0095-1137
dc.identifier.doi http://dx.doi.org/10.1128/JCM.00456-10
dc.identifier.other ITG-P1A
dc.identifier.other ITG-P2B
dc.identifier.other ITG-M4B
dc.identifier.other ITG-P5B
dc.identifier.other ITG-P6A
dc.identifier.other ITG-MLA
dc.identifier.other MULTI
dc.identifier.other PARAS
dc.identifier.other U-PROTO
dc.identifier.other U-SEROL
dc.identifier.other MICRO
dc.identifier.other U-HIVSTD
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other Abstract
dc.identifier.other UPD24
dc.identifier.other FTC
dc.identifier.uri http://hdl.handle.net/10390/6268
dc.description.abstract BACKGROUND: Accuracy of HIV diagnostic tests in tropical infections is poorly documented. Human African trypanosomiasis (HAT) is characterized by a polyclonal B-cell activation, constituting a risk for false positive reactions in diagnostic tests, including HIV tests. METHODS: A retrospective HIV diagnostic test accuracy study was performed on 360 human African trypanosomiasis (HAT) patients infected with T.b. gambiense before treatment, and 163 patients 2 years after successful treatment in Mbuji Mayi, East Kasai, DR Congo. Sensitivity, specificity and positive predictive value (PPV) of individual tests and algorithms consisting of 3 rapid tests were determined. RESULTS: Sensitivity for all tests was 100% (11/11). Low specificity (96.3%, 335/348) and PPV (45.8%, 11/24) of a classical seroconfirmation strategy (Vironostika ELISA followed by Line Immunoassay) complicated determination of the HIV status, which had to be determined by PCR. Specificities of rapid diagnostic tests were 39.1% for Determine (136/348), 85.3-92.8% (297/348-323/348) for VIKIA, Immunoflow, Doublecheck and Bioline, and 96.6-98.3% (336/348-342/348) for UniGold, Oraquick and STAT-PAK. Specificity for Vironostika was 67.5% (235/348). PPVs ranged between 4.9 and 64.7%. Combining 3 different rapid tests resulted in specificities of 98.3-100% (342-348/348) and PPVs of 64.7-100% (11/17-11/11). In cured HAT patients, specificities were significantly higher for Vironostika, Determine, Unigold and Immunoflow. CONCLUSIONS: T.b. gambiense infection decreases the specificity of antibody detection tests for HIV diagnosis. Unless tests have been validated for interference with HAT, HIV diagnosis in untreated HAT using classical algorithms should be avoided. Specific, validated combinations of 3 HIV rapid tests can increase specificity en
dc.language English en
dc.subject Viral diseases en
dc.subject HIV en
dc.subject AIDS en
dc.subject Protozoal diseases en
dc.subject Trypanosomiasis, African en
dc.subject Sleeping sickness en
dc.subject Trypanosoma brucei gambiense en
dc.subject Vectors en
dc.subject Tsetse flies en
dc.subject Diagnostics en
dc.subject Rapid diagnostic tests en
dc.subject False-positive en
dc.subject Accuracy en
dc.subject Specificity en
dc.subject Sensitivity en
dc.subject Predictive value en
dc.subject Performance en
dc.subject Congo-Kinshasa en
dc.subject Africa, Central en
dc.title Low specificities of HIV diagnostic tests caused by Trypanosoma brucei gambiense sleeping sickness en
dc.type Article en
dc.citation.issue 8 en
dc.citation.jtitle Journal of Clinical Microbiology en
dc.citation.volume 48 en
dc.citation.pages 2836-2839 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/20573878
dc.citation.jabbreviation J Clin Microbiol en


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