Challenges of Discrepant HIV Tests in Pregnant Women in the PrEP era-to Treat or Not to Treat?
Adult
Anti-HIV Agents
/ therapeutic use
Antiretroviral Therapy, Highly Active
Clinical Decision-Making
Disease Management
Female
HIV
/ genetics
HIV Infections
/ diagnosis
Humans
Kenya
Mass Screening
Polymerase Chain Reaction
Pre-Exposure Prophylaxis
/ methods
Pregnancy
Pregnancy Complications, Infectious
/ diagnosis
Prenatal Care
HIV retesting
discrepant results
indeterminate results
peripartum
preexposure prophylaxis
pregnancy
repeat HIV testing
Journal
The Journal of infectious diseases
ISSN: 1537-6613
Titre abrégé: J Infect Dis
Pays: United States
ID NLM: 0413675
Informations de publication
Date de publication:
03 02 2021
03 02 2021
Historique:
received:
09
04
2020
accepted:
11
06
2020
pubmed:
21
6
2020
medline:
7
9
2021
entrez:
21
6
2020
Statut:
ppublish
Résumé
During HIV retesting in antenatal and preexposure prophylaxis (PrEP) care, discrepant results occur, but guidelines are lacking. In a Kenyan trial implementing antenatal PrEP, if 1 test is reactive, a second is performed; if discrepant, both are repeated; if persistently discrepant, DNA polymerase chain reaction (PCR) is performed. Among 4451 women, 23 265 HIV retesting sessions were performed; 14 (0.06%, 95% confidence interval, 0.03%-0.10%) had discrepant results among 10 individuals; in all 10 initial cases, PCR was negative. Discrepant rapid tests are an expected, rare, and important challenge for antenatal care HIV retesting, with and without PrEP. NCT03070600.
Sections du résumé
BACKGROUND
During HIV retesting in antenatal and preexposure prophylaxis (PrEP) care, discrepant results occur, but guidelines are lacking.
METHODS
In a Kenyan trial implementing antenatal PrEP, if 1 test is reactive, a second is performed; if discrepant, both are repeated; if persistently discrepant, DNA polymerase chain reaction (PCR) is performed.
RESULTS
Among 4451 women, 23 265 HIV retesting sessions were performed; 14 (0.06%, 95% confidence interval, 0.03%-0.10%) had discrepant results among 10 individuals; in all 10 initial cases, PCR was negative.
CONCLUSIONS
Discrepant rapid tests are an expected, rare, and important challenge for antenatal care HIV retesting, with and without PrEP.
CLINICAL TRIALS REGISTRATION
NCT03070600.
Identifiants
pubmed: 32561928
pii: 5860162
doi: 10.1093/infdis/jiaa343
pmc: PMC7857350
doi:
Substances chimiques
Anti-HIV Agents
0
Banques de données
ClinicalTrials.gov
['NCT03070600']
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
234-237Subventions
Organisme : NIAID NIH HHS
ID : K01 AI116298
Pays : United States
Organisme : NIMH NIH HHS
ID : K01 MH121124
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI125498
Pays : United States
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.