The World Health Organization strongly recommended test
algorithm for diagnosis of Human Immunodeficiency Virus (HIV) infection. In either
parallel or serial algorithms, discordance is commonly encountered and the final
result has to be determined by the use of a tie breaker.
The objective of this study is to evaluate the accuracy
of HIV rapid test results resolved by tie breaker in a serial algorithm using Western
Blot as gold standard.
total of 110 remnant samples reactive as positive by Determine but giving discordant
result with Unigold were collected and retested by national (serial) algorithm from
January 2013 to July 2013. Samples were collected in either plain bottles or EDTA
container by staff conducting HIV rapid test and transported/stored at 2-8 degree
Celsius. Samples were tested according to manufactures leaflet insert. The final
result obtained with the serial algorithm was verified with Western Blot technique.
of the 10 discordant results, 9 were confirmed HIV positive by serial algorithm
but only 8 were confirmed positive by Western Blot technique. Thus, there was 1(11%)
false positive obtained with serial algorithm. Samples that were reactive by Determine
were 110 (100%), 94(85.5%) reactive for Unigold and 93(85%) reactive results with
out of every 9 HIV results resolved by tie breaker as positive is false positive.
This accounts for 11%. There is need therefore to introduce further means of verifying
positive results resolved by tie breaker to avoid placing patients on anti retro
vial drugs wrongly and subjecting people to psychological trauma.
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