Second Test Helps Prevent Incorrect HIV Diagnosis
|
By LabMedica International staff writers Posted on 06 Dec 2017 |
|
The specificity of nucleic acid amplification tests (NAATs) used for early infant diagnosis (EID) of human immunodeficiency virus (HIV) infection is less than 100%, leading some HIV-uninfected infants to be incorrectly identified as HIV-infected.
Without confirmatory testing, 128 of every 1000 infants initiating antiretroviral therapy (ART) were actually HIV-uninfected, due to false-positive diagnoses; with confirmatory testing, only 1 out of 1,000 infants initiating ART was truly uninfected.
A team of scientists working under the auspices of the University of Cape Town (Cape Town, South Africa) examined the impact of a second NAAT in infants to confirm a first positive result. They assumed a NAAT cost of USD 25, specificity of 99.6%, and sensitivity of 100%. The team used the Cost-effectiveness of Preventing AIDS Complications (CEPAC)–Pediatric model, and simulated EID testing at age six weeks for HIV-exposed infants without and with confirmatory testing. After diagnosis, infants were linked to and retained in care for 10 years (false-positive) or lifelong (true-positive).
Both without and with confirmatory testing, life-expectantly (LE) was 26.2 years for HIV-infected infants and 61.4 years for all HIV-exposed infants; clinical outcomes for truly infected infants did not differ by strategy. Because confirmatory testing averted costly HIV care and ART in truly HIV-uninfected infants, it was cost-effective: total cost USD 1,790/infant tested, compared to USD 1,830/infant tested without confirmatory testing. Confirmatory testing remained cost-effective unless NAAT cost exceeded USD 400 or the HIV-uninfected status of infants incorrectly identified as infected was ascertained and ART stopped within three months of starting.
Andrea Ciaranello, MD, MPH, an assistant professor at Massachusetts General Hospital (Boston, MA, USA) and senior author of the study, said, “While projected cost differences are small, confirmatory testing is likely to be cost-saving under a wide range of scenarios in South Africa. Concerns about the cost of the second test itself should not be the reason to avoid this important intervention.” The study was published on November 21, 2017, in the journal Public Library of Science Medicine.
Related Links:
University of Cape Town
Massachusetts General Hospital
Without confirmatory testing, 128 of every 1000 infants initiating antiretroviral therapy (ART) were actually HIV-uninfected, due to false-positive diagnoses; with confirmatory testing, only 1 out of 1,000 infants initiating ART was truly uninfected.
A team of scientists working under the auspices of the University of Cape Town (Cape Town, South Africa) examined the impact of a second NAAT in infants to confirm a first positive result. They assumed a NAAT cost of USD 25, specificity of 99.6%, and sensitivity of 100%. The team used the Cost-effectiveness of Preventing AIDS Complications (CEPAC)–Pediatric model, and simulated EID testing at age six weeks for HIV-exposed infants without and with confirmatory testing. After diagnosis, infants were linked to and retained in care for 10 years (false-positive) or lifelong (true-positive).
Both without and with confirmatory testing, life-expectantly (LE) was 26.2 years for HIV-infected infants and 61.4 years for all HIV-exposed infants; clinical outcomes for truly infected infants did not differ by strategy. Because confirmatory testing averted costly HIV care and ART in truly HIV-uninfected infants, it was cost-effective: total cost USD 1,790/infant tested, compared to USD 1,830/infant tested without confirmatory testing. Confirmatory testing remained cost-effective unless NAAT cost exceeded USD 400 or the HIV-uninfected status of infants incorrectly identified as infected was ascertained and ART stopped within three months of starting.
Andrea Ciaranello, MD, MPH, an assistant professor at Massachusetts General Hospital (Boston, MA, USA) and senior author of the study, said, “While projected cost differences are small, confirmatory testing is likely to be cost-saving under a wide range of scenarios in South Africa. Concerns about the cost of the second test itself should not be the reason to avoid this important intervention.” The study was published on November 21, 2017, in the journal Public Library of Science Medicine.
Related Links:
University of Cape Town
Massachusetts General Hospital
Gold Member
Fully Automated Cell Density/Viability Analyzer
BioProfile FAST CDV
New
Centrifuge
Hematocrit Centrifuge 7511M4
New
High Performance Centrifuge
CO336/336R
Latest Microbiology News
- Handheld Device Delivers Low-Cost TB Results in Less Than One Hour
- New AI-Based Method Improves Diagnosis of Drug-Resistant Infections
- Breakthrough Diagnostic Technology Identifies Bacterial Infections with Almost 100% Accuracy within Three Hours
- Innovative ID/AST System to Help Diagnose Infectious Diseases and Combat AMR
- Gastrointestinal Panel Delivers Rapid Detection of Five Common Bacterial Pathogens for Outpatient Use
- Rapid PCR Testing in ICU Improves Antibiotic Stewardship
- Unique Genetic Signature Predicts Drug Resistance in Bacteria
- Unique Barcoding System Tracks Pneumonia-Causing Bacteria as They Infect Blood Stream
- Rapid Sepsis Diagnostic Test Demonstrates Improved Patient Care and Cost Savings in Hospital Application
- Rapid Diagnostic System to Detect Neonatal Sepsis Within Hours
- Novel Test to Diagnose Bacterial Pneumonia Directly from Whole Blood
- Interferon-γ Release Assay Effective in Patients with COPD Complicated with Pulmonary Tuberculosis
- New Point of Care Tests to Help Reduce Overuse of Antibiotics
- 30-Minute Sepsis Test Differentiates Bacterial Infections, Viral Infections, and Noninfectious Disease
- CRISPR-TB Blood Test to Enable Early Disease Diagnosis and Public Screening
- Syndromic Panel Provides Fast Answers for Outpatient Diagnosis of Gastrointestinal Conditions
Channels
Clinical Chemistry
view channel
‘Brilliantly Luminous’ Nanoscale Chemical Tool to Improve Disease Detection
Thousands of commercially available glowing molecules known as fluorophores are commonly used in medical imaging, disease detection, biomarker tagging, and chemical analysis. They are also integral in... Read more
Low-Cost Portable Screening Test to Transform Kidney Disease Detection
Millions of individuals suffer from kidney disease, which often remains undiagnosed until it has reached a critical stage. This silent epidemic not only diminishes the quality of life for those affected... Read more
New Method Uses Pulsed Infrared Light to Find Cancer's 'Fingerprints' In Blood Plasma
Cancer diagnoses have traditionally relied on invasive or time-consuming procedures like tissue biopsies. Now, new research published in ACS Central Science introduces a method that utilizes pulsed infrared... Read more
Molecular Diagnostics
view channel
Blood Biomarker Test Could Detect Genetic Predisposition to Alzheimer’s
New medications for Alzheimer’s disease, the most common form of dementia, are now becoming available. These treatments, known as “amyloid antibodies,” work by promoting the removal of small deposits from... Read more
Novel Autoantibody Against DAGLA Discovered in Cerebellitis
Autoimmune cerebellar ataxias are strongly disabling disorders characterized by an impaired ability to coordinate muscle movement. Cerebellar autoantibodies serve as useful biomarkers to support rapid... Read more
Gene-Based Blood Test Accurately Predicts Tumor Recurrence of Advanced Skin Cancer
Melanoma, an aggressive form of skin cancer, becomes extremely difficult to treat once it spreads to other parts of the body. For patients with metastatic melanoma tumors that cannot be surgically removed... Read more
Hematology
view channel
New Scoring System Predicts Risk of Developing Cancer from Common Blood Disorder
Clonal cytopenia of undetermined significance (CCUS) is a blood disorder commonly found in older adults, characterized by mutations in blood cells and a low blood count, but without any obvious cause or... Read more
Non-Invasive Prenatal Test for Fetal RhD Status Demonstrates 100% Accuracy
In the United States, approximately 15% of pregnant individuals are RhD-negative. However, in about 40% of these cases, the fetus is also RhD-negative, making the administration of RhoGAM unnecessary.... Read more
Immunology
view channel
Stem Cell Test Predicts Treatment Outcome for Patients with Platinum-Resistant Ovarian Cancer
Epithelial ovarian cancer frequently responds to chemotherapy initially, but eventually, the tumor develops resistance to the therapy, leading to regrowth. This resistance is partially due to the activation... Read more
Machine Learning-Enabled Blood Test Predicts Immunotherapy Response in Lymphoma Patients
Chimeric antigen receptor (CAR) T-cell therapy has emerged as one of the most promising recent developments in the treatment of blood cancers. However, over half of non-Hodgkin lymphoma (NHL) patients... Read more
Pathology
view channel
Novel UV and Machine Learning-Aided Method Detects Microbial Contamination in Cell Cultures
Cell therapy holds great potential in treating diseases such as cancers, inflammatory conditions, and chronic degenerative disorders by manipulating or replacing cells to restore function or combat disease.... Read more
New Error-Corrected Method to Help Detect Cancer from Blood Samples Alone
"Liquid biopsy" technology, which relies on blood tests for early cancer detection and monitoring cancer burden in patients, has the potential to transform cancer care. However, detecting the mutational... Read more
"Metal Detector" Algorithm Hunts Down Vulnerable Tumors
Scientists have developed an algorithm capable of functioning as a "metal detector" to identify vulnerable tumors, marking a significant advancement in personalized cancer treatment. This breakthrough... Read more
Novel Technique Uses ‘Sugar’ Signatures to Identify and Classify Pancreatic Cancer Cell Subtypes
Pancreatic cancer is often asymptomatic in its early stages, making it difficult to detect until it has progressed. Consequently, only 15% of pancreatic cancers are diagnosed early enough to allow for... Read moreTechnology
view channel
Disposable Microchip Technology Could Selectively Detect HIV in Whole Blood Samples
As of the end of 2023, approximately 40 million people globally were living with HIV, and around 630,000 individuals died from AIDS-related illnesses that same year. Despite a substantial decline in deaths... Read more
Pain-On-A-Chip Microfluidic Device Determines Types of Chronic Pain from Blood Samples
Chronic pain is a widespread condition that remains difficult to manage, and existing clinical methods for its treatment rely largely on self-reporting, which can be subjective and especially problematic... Read more
Innovative, Label-Free Ratiometric Fluorosensor Enables More Sensitive Viral RNA Detection
Viruses present a major global health risk, as demonstrated by recent pandemics, making early detection and identification essential for preventing new outbreaks. While traditional detection methods are... Read more
Industry
view channel
Cepheid and Oxford Nanopore Technologies Partner on Advancing Automated Sequencing-Based Solutions
Cepheid (Sunnyvale, CA, USA), a leading molecular diagnostics company, and Oxford Nanopore Technologies (Oxford, UK), the company behind a new generation of sequencing-based molecular analysis technologies,... Read more
Grifols and Tecan’s IBL Collaborate on Advanced Biomarker Panels
Grifols (Barcelona, Spain), one of the world’s leading producers of plasma-derived medicines and innovative diagnostic solutions, is expanding its offer in clinical diagnostics through a strategic partnership... Read more
