Field comparison of OraQuick W ADVANCE Rapid HIV-1/2 antibody test and two blood-based rapid HIV antibody tests in Zambia (original) (raw)
Background: Zambia's national HIV testing algorithm specifies use of two rapid blood based antibody assays, Determine W HIV-1/2 (Inverness Medical) and if positive then Uni-Gold TM Recombigen HIV-1/2 (Trinity Biotech). Little is known about the performance of oral fluid based HIV testing in Zambia. The aims of this study are twofold: 1) to compare the diagnostic accuracy (sensitivity and specificity) under field conditions of the OraQuick W ADVANCE W Rapid HIV-1/2 (OraSure Technologies, Inc.) to two blood-based rapid antibody tests currently in use in the Zambia National Algorithm, and 2) to perform a cost analysis of large-scale field testing employing the OraQuick W. Methods: This was a operational retrospective research of HIV testing and questionnaire data collected in 2010 as part of the ZAMSTAR (Zambia South Africa TB and AIDS reduction) study. Randomly sampled individuals in twelve communities were tested consecutively with OraQuick W test using oral fluid versus two blood-based rapid HIV tests, Determine W and Uni-Gold TM. A cost analysis of four algorithms from health systems perspective were performed: 1) Determine W and if positive, then Uni-Gold TM (Determine W /Uni-Gold TM); based on current algorithm, 2) Determine W and if positive, then OraQuick W (Determine W /OraQuick W), 3) OraQuick W and if positive, then Determine W (OraQuick W /Determine W), 4) OraQuick W and if positive, then Uni-Gold TM (OraQuick W /Uni-Gold TM). This information was then used to construct a model using a hypothetical population of 5,000 persons with varying prevalence of HIV infection from 1–30%.
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