As HIV-2 is intrinsically resistant to nonnucleoside reverse transcriptase inhibitors, it is mandatory to discriminate between HIV types before initiating antiretroviral treatment. Guinea-Bissau has the world's highest prevalence of HIV-2 and HIV-1/HIV-2 dually infected individuals. We evaluated 3 rapid tests for discrimination between HIV-1, HIV-2, and dual infections among 219 patients from Guinea-Bissau by comparing with the gold standard (INNO-LIA). Genie III HIV-1/HIV-2 was the best performer with regard to discriminatory capacity (agreement 91.8%), followed by Immunoflow HIV1-HIV2 (agreement 90.9%) and SD Bioline HIV-1/2 3.0 (agreement 84.5%). Our results underscore the need for evaluation of tests in relevant populations before implementation.
*Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark;
†Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau;
‡National HIV Programme, Ministry of Health, Bissau, Guinea-Bissau;
§National Public Health Laboratory, Bissau, Guinea-Bissau;
‖GloHAU, Center for Global Health, School of Public Health, Aarhus University, Aarhus, Denmark; and
¶Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark.
Correspondence to: Bo Langhoff Hønge, MD, Department of Infectious Diseases, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus, Denmark (e-mail: firstname.lastname@example.org).
Supported by AIDS-fondet, Denmark, and the National Institute of Public Health (INASA), Bissau, Guinea-Bissau. Routine data collection was supported by “Secretariado National de Luta contra o Sida” in Guinea-Bissau. Innogenetics provided reagents for HIV-1/HIV-2 antibody immunoblot (INNO-LIA). Bio-Rad provided rapid tests (Genie III HIV-1/HIV-2).
The authors have no conflicts of interest to disclose.
B.L.H., M.P.B.O., and C.E. conceived the study; B.L.H., M.P.B.O. and C.E. designed the study protocol; C.M., D.d.S.T., and Z.J.d.S. carried out the clinical assessment; B.L.H. and M.P.B.O. carried out the rapid testing; B.L.H., S.J., C.W., L.Ø., and C.E. carried out the analysis and interpretation of these data. B.L.H., M.P.B.O., and C.E. drafted the manuscript; S.J., C.W., and L.Ø. critically revised the manuscript for intellectual content. All authors read and approved the final manuscript. B.L.H., C.W., and C.E. are guarantors of the paper. Co-first authorship: We wish to submit this manuscript with 2 first authors; B.L.H. and M.P.B.O. These two authors have contributed equally in the process of performing the study and in writing the manuscript.
The Bissau HIV Cohort Study Group comprises A. Rodrigues, D.d.S., Z.d.S., C.M., I. Oliviera-Souto, L.Ø., A.L.L., M. Sodemann, P. Aaby, A. Fomsgaard, C.E., J. Eugen-Olsen, and C.W. (chair).
Received May 29, 2013
Accepted July 12, 2013