Inconclusive results with HIV serodiagnosis algorithms, and HIV-1 and HIV-2 co-infection in North-eastern Democratic Republic of Congo

Background:Inconclusive serodiagnosis of HIV infection is particularly frequent in Central Africa. The aims of this study were to: (i) determine the rate of inconclusive results with the two-test algorithm that the WHO proposed in 1997 (WHO II) versus the three-test algorithm (revised in 2012 and consolidated in 2015 by WHO) for HIV testing, and (ii) determine the prevalence of HIV-1 and HIV-2 co-infection in the north-eastern region of the Democratic Republic of the Congo (DRC).Methods:A multicentre cross-sectional study was performed between March and June 2016 in Kisangani and Bunia, the capital cities of Tshopo and Ituri provinces respectively. Alere Determine HIV-1/2 (Alere Medical Co. Ltd., Japan), Uni-GoldTM HIV (Trinity Biotech Manufacturing Ltd., Ireland) and recomLine HIV-1 and HIV-2 IgG (Biosynex, France) were the first, second and third tests in the serial algorithm.Results : The rate of inconclusive results was 1.1% (95% CI: 0.4 to 3.1) with the two-test algorithm and 0.4% (95% CI: 0.1 to 2.1) with the three-test algorithm (p less than 0.001). The prevalence of HIV-1 and HIV-2 co-infection among HIV positive sera was 16.7% (95% CI: 4.7 to 44.8).Conclusion:The three-test algorithm HIV testing strategy significantly reduces the rate of inconclusive results. In addition, the prevalence of HIV-1 and HIV-2 co-infection is higher in a context where HIV-2 infection is poorly documented. Large-scale research is essential to clarify these results

Factors Associated with HIV Testing and Receiving Results during Antenatal Care in Tanzania

Mother to child transmission of HIV (MTCT) control goal is achievable when all pregnant mothers test for HIV and collect the results enabling timely eligibility and access to anti-retroviral therapy (ART). This study aimed to determine factors associated with uptake of HIV testing during antenatal care in Tanzania. Using 2011-2012 Tanzania HIV and Malaria Indicator Survey data; 3555 women who attended antenatal clinic and delivered in the last two years were analyzed. One was considered HIV tested if she took HIV test and collected results. Bivariate and multivariate analysis was done using STATA version 12. High proportion (76) tested for HIV during antenatal care; factors significantly associated (p0.05) with testing included receiving information on HIV testing during antenatal care; age; education and wealth. Proportion taking HIV test was high; prevention of MTCT (PMTCT) strategies should focus on increasing information on testing during antenatal care (ANC); targeting the young; less educated and poor

HIV Counselling and Testing Utilisation and Attitudes of Male Inmates in a South African Prison

The Department of Correctional Services Policy on the management of HIV and AIDS for offenders include voluntary counselling and testing (VCT) for HIV as one of the priorities in the rehabilitation of inmates. The aim of this study was to determine factors associated with the utilisation of VCT services in the correctional centres in terms of level of satisfaction; their experiences and expectations; and motivating factors and barriers for VCT utilisation at Losperfontein Correctional Centre; South Africa. This was a case control study (cases being those who underwent testing and controls those who did not) examining predictors of HIV VCT utilisation among 200male adult sentenced inmates serving medium and maximum sentences. Results indicate that a poor health system (OR=0.34; 95CI:0.23 - 0.50) was inversely associated with HIV testing acceptance in prison; while age; educational level; population group; marital status; length of incarceration and access to HIV testing in prison were not associated with HIV testing acceptance in prison. Half of the participants (50) agreed that VCT services are accessible and are promoted at their correctional centre. Most were satisfied with different components of VCT services; ranging from 79 (fair to very good) for 'the way he/she received you' to 62 'clarified all your concerns'. This study demonstrated some challenges and benefits to the field of health promotion and HIV prevention in the correctionalcentres especially with regard to VCT services

'When I Get Better I will do the Test': Facilitators and Barriers to HIV Testing in Northwest Region of Cameroon with Implications for TB and HIV/AIDS Control Programmes

The World Health Organization has recommended collaborative activities between TB and HIV programmes with routine counselling and testing for HIV among TB patients in order to improve the uptake of HIV services. We carried out qualitative research interviews with 21 TB patients in four selected TB and HIV/AIDS treatment centres in the Northwest Region of Cameroon to explore the facilitators and barriers to HIV testing. The desire to be healthy and live longer from knowing one's status inspired by the anticipated support from loved ones; faith in a supreme being; influence and trust in the medical authority; encouraged HIV testing. Men also demonstrated their masculinity by testing; thus portraying themselves as positive role models for other men. Meanwhile; the overwhelming burden of facing both TB and HIV simultaneously; influenced by the fear of disclosure of results; harmful gender norms and practices; fear of stigma and discrimination; and misconceptions surrounding HIV/AIDS deterred HIV testing. However; as a result of conflicting emotional experiences regarding to test or not to test; the decision-making process was not straightforward and this complex process needs to be acknowledged by health care providers when advocating for routine HIV testing among TB patients

Quality of HIV laboratory testing in Tanzania: a situation analysis

Tanzania is scaling up prevention; treatment; care and support of individuals affected with HIV. There is therefore a need for high quality and reliable HIV infection testing and AIDS staging. The objective of this study was to assess laboratories capacities of services in terms of HIV testing and quality control. A baseline survey was conducted from December 2004 to February 2005 in 12 laboratories which were conveniently selected to represent all the zones of Tanzania. The questionnaires comprised of questions on laboratory particulars; internal and external quality control for HIV testing and quality control of reagents. Source and level of customer satisfaction of HIV test kits supply was established. Of 12 laboratories; nine used rapid tests for screening and two used rapid tests for diagnosis. In the 12 laboratories; four used double ELISA and five used single ELISA and three did not use ELISA. Confirmatory tests observed were Western Blot in three laboratories; DNA PCR in two laboratories; CD4 counting in seven laboratories; and viral load in two laboratories. Although all laboratories conducted quality control (QC) of the HIV kits; only two laboratories had Standard Operating Procedures (SOPs). Internal and external quality control (EQC) was done at varied proportions with the highest frequency of 55.6(5/9) for tnternal quality control (IQC) for rapid tests and EQC for ELISA; and the lowest frequency of 14.3(1/ 7) for IQC for CD4 counting. None of the nine laboratories which conducted QC for reagents used for rapid tests and none of the five which performed IQC and EQC had SOPs. HIV kits were mainly procured by the Medical Store Department and most of laboratories were not satisfied with the delay in procurement procedures. Most of the laboratories used rapid tests only; while some used both rapid tests and ELISA method for HIV testing. In conclusion; the survey revealed inadequacy in Good Laboratory Practice and poor laboratory quality control process for HIV testing reagents; internal and external quality control

Ugandan HIV-1 strains with unusual antigenicity

Recent reports have documented that certain HIV-1 antibody tests may not reliably detect divergent variants of HIV-1; provisionally classified as HIV-1 group O. Although most known cases of group O infections are found in Cameroon; the prevalence and worldwide distribution of these unusual variants is unclear. In Uganda; where serveral HIV-1 subtypes have been identified; approximately 15of confirmed HIV-1-positive specimens tested negative using an in-house peptide enzyme immunoassay (PLEA) based on the immuno-dominant region of gp41 (QQLLGIWGCSGKLICTT) of the prototypic HIV-1 strain LAI. This result prompted us to further investigate these specimens using PEIA's based on the representative V3-loops of each known serotype; including group O (ANT70 and MVP5180) sequences; and other immuno-dominant petides representing the genetic groups M (LAI and ELI) and O (MVP518 and ANT70). No group O infections were found among these samples. This was confirmed by genetic analysis of the C2V3 region of the envelope protein (gp 20) and/or the immuno-dominant region pf the gp41. Our analysis showed that a single amino-acid substitution (leuu to His) in position607 of gp41; was associated with the diminished sero-reactivity with the immuno-dominant gp41 peptide baserd on LAI. Since synthetic peptides with similar sequences are being used in many commercial third-generation assays for HIV-1; our findings indicate the need to evaluate the performance of these assays before they are used in Uganda. The results of these evaluations may be useful in developing improved diagnostic assays for HIV-1 in Uganda and other African countries

L'epreuve serologique dans les suspicions cliniques d'infection a VIH a Niamey : a propos de 2350 prelevements

Dans ce travail; 2350 demandes de confirmation serologique des suspicions cliniques d'infection a VIH a Niamey sont examinees. 430 malades suspects sont seropositifs; soit une prevalence globale de 18;29 pour cent. Il n'y a pas de difference significative par rapport au sexe. Dans plus de 76 pour cent des cas; ces seropositifs avaient entre 16 et 45 ans. Le profil VIH-1 predomine avec une frequence de 67;21 pour cent; viennent ensuite le double profil VIH-1 + VIH-2 avec 21;63 pour cent et le profil VIH-2 avec 11;16 pour cent. Les quatre premiers motifs cliniques de suspicion sont la diarrhee chronique; l'amaigrissement important; la fievre au long cours et les infections pulmonaires

Reutilizacao de um teste simples e rapido para o rastreio de IgG Anti-HIV-1 et 2 (comunicacao curta)

Avaliamos a reutilizacao do HIV-SPOT; u teste comercial simples e rapido para a deteccao de anticorpos contra HIV-1et2; apos sustituicao do conjugado original por anti-IgG humana conjugado a fosfatase alcaline. Para a primeira e segunda reutilizacao; os substractos BCIP e BCIP+NBT foram respectivamente adicionados. Num panel de 72 soros com diferentes reactividades anti-HIV por ELISA e Westem blot (nehum positivo); colectado a pacientes suspeitos de doenca associada ao SIDA; observamos uma total concordancia com o procedimento original. A reducio dos custos em reagentes com este algoritmo; foi estimada entre 52.5 por centon e 40.6 por cento para seroprevalencias de HIV entre 5 por centos; respectivamente

Les manifestations buccales du SIDA

Au moment ou il devient de plus en plus difficile pour les patients d'acceder aux tests de diagnostic a cause du cout eleve; il est important que le chirurgien-dentiste puisse mieux maitriser la connaissance des manifestations buccales du SIDA afin de pouvoir les convaincre et de se confier a d'autres professionnels de la sante rodes dans la prise en chargede l'infection au VIH

Clinical presentation of HIV infection and AIDS in Tanzania

Several new syndromes; a typical presentation of well known diseases as well as increase in endemic opportunistic infections have become common in the recent past following advent of HIV. HIV can be said to have replaced syphilis as the greatest imitator

Clinical presentation of HIV infection and AIDS in surgery: Tanzanian experience

Reports of various studies conducted in one of the three general surgical firms of Muhimbili Medical Centre on opportunistic diseases common in surgical practice occurring in HIV/AIDS subjects is presented. Cervical lymphadenopathy in these subjects due to tuberculosis; non-specific adenitis; and Kaposi's sarcoma were found to be common; while lymphomas were rare. Pyomyositis; Kaposi's sarcoma; throactic empyema and pericardial effusion occur in a significant number of these patients. An attempt is made to establish the pattern of the various clinical manifestations in HIV/AIDS subjects

Evaluation of rapid tests for HIV antibody screening of blood donors

The enzyme-linked immunosorbent assay (ELISA) is currently the most accepted method used to screen for antibodies to HIV Conventional ELISA assays require from 1.5 to 3.5 hours to complete and an optical density (OD) reader to record results. We have therefore considered the applicability of using rapid tests for the screening of blood donors. The Testpack method is quick to perform; easy to interpret and sensitive. Results indicate that the Testpack method is suitable for the screening of blood donors and in emergency situations

Clinical and laboratory characteristics of HIV-1 infection in Zimbabwe

To define the impact of human immunolodeficiency virus (HIV) infection in Africa; clinical and laboratory investigations were conducted on 265 HIV-seropositive outpatients in Zimbabwe. Twenty-four of the study subjects were asymptomatic (ASX); 124 had persistent generalized lympademopathy (PGL); and 117 had AIDS-related complex (ARC). HIV infection was assessed by commercial ELISA; Western blots; synthetic peptide ELISA; and measurement of p24 antigen. Serum immunoglobulins; lympocyte mitogen responses; and CD4+ cell numbers were obrtained in 54 sequential patients. Compared to seronegative subjects meab CD4+ cell numbers were decreased and serum immunoglobulins; particularly IgM and IgG; were increased in all groups of seropositive subjects. [abstract terminated]