Sensitivity and specificity of rapid HIV testing of pregnant women in India.

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Int J STD AIDS. 2003 Jan;14(1):37-41.

Sensitivity and specificity of rapid HIV testing of pregnant women in

India.

Bhore AV, Sastry J, Patke D, Gupte N, Bulakh PM, Lele S, Karmarkar A,

Bharucha KE, Shrotri A, Pisal H, Suryawanshi N, Tripathy S, Risbud

AR, Paranjape RS, Shankar AV, Kshirsagar A, Phadke MA, Joshi PL,

Brookmeyer RS, Bollinger RC Jr.

Department of Microbiology, BJ Medical College/Sassoon Hospital,

Pune, India. shilpa_v_lele@...

OBJECTIVE: Efforts to prevent HIV transmission from mother to infants

in settings like India may benefit from the availability of reliable

methods for rapid and simple HIV screening. Data from India on the

reliability of rapid HIV test kits are limited and there are no data

on the use of rapid HIV tests for screening of pregnant women.

METHODS: Pregnant women attending an antenatal clinic and delivery

room in Pune agreed to participate in an evaluation of five rapid HIV

tests, including (a) a saliva brush test (Oraquick HIV-1/2, Orasure

Technologies Inc.), ( a rapid plasma test (Oraquick HIV-1/2) and

© three rapid finger prick tests (Oraquick HIV-1/2; HIV-1/2

Determine, Abbott; NEVA HIV-1/2 Cadila). Results of the rapid tests

were compared with three commercial plasma enzyme immunoassay (EIA)

tests (Innotest HIV AB EIA, Lab systems/ELISCAN HIV AB EIA, UBI HIV

Ab EIA).

RESULTS: Between September 2000 and October 1, 2001, 1258 pregnant

women were screened for HIV using these rapid tests. Forty-four

(3.49%) of the specimens were HIV-antibody-positive by at least two

plasma EIA tests. All of the rapid HIV tests demonstrated excellent

specificity (96-100%). The sensitivity of the rapid tests ranged from

75-94%. The combined sensitivity and specificity of a two-step

algorithm for rapid HIV testing was excellent for a number of

combinations of the five rapid finger stick tests.

CONCLUSION: In this relatively low HIV prevalence population of

pregnant women in India, the sensitivity of the rapid HIV tests

varied, when compared to a dual EIA algorithm. In general, the

specificity of all the rapid tests was excellent, with very few false

positive HIV tests. Based upon these data, two different rapid HIV

tests for screening pregnant women in India would be highly

sensitive, with excellent specificity to reliably prevent

inappropriate use of antiretroviral therapy for prevention of

vertical HIV transmission.

BJ Medical College, Pune, India;

Mridula Phadke, MD 91-20-553-8962 drmapaa@...