Free Content HIV serological screening in a population of pregnant women in the Republic of Congo: suitability of different assays

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Abstract:

Summary

Different strategies can be applied for the screening of HIV infection, depending on the local seroprevalence. Within a WHO type III strategy, we compared the results of two different second-line methods for HIV screening of a population of pregnant women in the Republic of Congo. Sera from 3614 consecutive pregnant women were tested for HIV with Genescreen Plus Ag/Ab EIA assay; positive specimens were retested with two different second-line methods. (Determine HIV-1/2 rapid test and Vironostika HIV Ag/Ab specific EIA assay). Discordant samples were tested with HIV-1/2 Western Blot and, if necessary, HIV RNA molecular assay. Of the 3614 sera, 221 were positive with Genscreen. Among them, 21 and 10 tested negative with Vironostika and Determine, respectively. A 100% correspondence with 3rd line confirmation test results was found in Genscreen positive/Vironostika negative samples, whereas a 5.5% overestimation of HIV seroprevalence was observed when Determine, instead of Vironostika, was used as second-line test. The choice of appropriate assays in adequate sequence, within the correct WHO strategy, is pivotal to minimize the risk of overtreatment of HIV infection.

Keywords: HIV screening; Republic of Congo; WHO strategies; assays; pregnant women; prevalence

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1365-3156.2008.02090.x

Affiliations: 1:  Hygiene Unit, S. Martino Hospital, Genoa, Italy 2:  Division of Infectious Diseases, University of Genoa and San Martino University Hospital, Genoa, Italy 3:  Department of Health Sciences, University of Genoa, Genoa, Italy 4:  Kento-Muana Laboratory, Hôpital Régional des Armées, Pointe Noire, République du Congo 5:  ENI E & P, San Donato Milanese, Milan, Italy

Publication date: July 1, 2008

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