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Performance of the first fourth-generation rapid human immunodeficiency virus test in children
Kapila Bhowan1, Gayle G Sherman
1Paediatric HIV Diagnostic Syndicate, Wits Health Consortium, Parktown, South Africa. kbhowan@gmail.com
Insights
Point-of-care HIV diagnosis using p24 antigen tests can lower infant illness and death. However, a rapid test showed low sensitivity for p24 antigen but high accuracy for HIV antibodies in infants under six months.
Area of Science:
- Pediatrics
- Infectious Diseases
- Diagnostic Medicine
Background:
- Early diagnosis of HIV infection in infants is crucial for reducing morbidity and mortality.
- Point-of-care (POC) testing offers a promising strategy for timely infant HIV diagnosis.
Purpose of the Study:
- To evaluate the performance of a fourth-generation rapid test for diagnosing HIV in infants.
- To assess the test's ability to detect p24 antigen and HIV antibodies in pediatric samples.
Main Methods:
- A fourth-generation rapid HIV test was evaluated using 202 stored pediatric samples.
- The test's sensitivity for p24 antigen detection and HIV antibody detection was assessed in relation to infant age and HIV status.
Main Results:
- The rapid test demonstrated a sensitivity of less than 2% for detecting p24 antigen in HIV-infected infants.
- The test achieved 100% sensitivity and specificity for detecting HIV antibodies in infants aged 6 months and younger.
Conclusions:
- Current fourth-generation rapid tests show limited utility for p24 antigen detection in infants.
- These tests are highly accurate for HIV antibody detection in infants up to 6 months of age, supporting early diagnosis strategies.
Abstract:
Diagnosing HIV infection in infants by p24 antigen detection at point of care is likely to reduce infant morbidity and mortality. A fourth-generation rapid test evaluated on 202 stored samples from children of known age and clinical presentation demonstrated a sensitivity of <2% for detecting p24 antigen in 61 HIV-infected infants and demonstrated 100% sensitivity and specificity for detecting HIV antibodies in infants aged 6 months and younger.
