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Automatic oral fluid-based HIV testing in HIV screening programmes: automatic for the people.

M Rayment¹, E Doku, A Thornton

¹Directorate of HIV/GU Medicine, Chelsea and Westminster Hospital NHS Foundation Trust.

|September 17, 2013

Summary

Automating oral fluid HIV testing using the Abbott Architect platform is a viable option for large-scale screening. This method preserves test performance, reduces workload, and speeds up results, making it efficient for public health programs.

Keywords:

HIV testing acceptability oral fluid point-of-care testing sensitivity specificity

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Area of Science:

Clinical Diagnostics
Public Health Virology

Background:

UK guidelines advocate routine HIV testing in clinical settings with >0.2% local prevalence.
Pilot programs utilized manual laboratory-based testing of oral fluid samples.
Manual testing, while robust, was labor-intensive and demanding on clinical resources.

Purpose of the Study:

To validate the automation of oral fluid human immunodeficiency virus (HIV) testing.
To assess the feasibility of using the fourth-generation HIV test on the Abbott Architect platform for oral fluid samples.

Main Methods:

Oral fluid samples were collected from 143 patients using the Oracol+ device.
Samples were tested concurrently using manual (Genscreen Ultra) and automated (Abbott Architect) methods.
Agreement between platforms and with existing HIV serology was assessed.

Main Results:

100% agreement in results between manual and automated oral fluid testing platforms.
All test results aligned with established HIV serology.
High-quality samples were obtained using the Oracol+ device, with subsequent field use showing 99.97% specificity.

Conclusions:

Automated oral fluid HIV testing on the Abbott Architect platform is a viable option for large-scale screening.
Automation preserves test performance while reducing laboratory workload and accelerating result turnaround.
This approach is acceptable to patients and requires less training and fewer clinical resources compared to near-patient testing.