Reducing False-Positive Results With Fourth-Generation HIV Testing at a Veterans Affairs Medical Center.
Journal
Federal practitioner : for the health care professionals of the VA, DoD, and PHS
ISSN: 1078-4497
Titre abrégé: Fed Pract
Pays: United States
ID NLM: 9500574
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
entrez:
28
6
2021
pubmed:
29
6
2021
medline:
29
6
2021
Statut:
ppublish
Résumé
In 2006, the Centers for Disease Control and Prevention issued guidelines advocating routine HIV screening for all patients. However, false-positive results are a potential patient care threat for low-risk populations even with accurate screening assays. A reduction in HIV false-positive screening results can potentially be seen by switching from the third-generation to a more sensitive and specific fourth-generation screening assay. We studied the impact on the false-positive screening rate of a change to a fourth-generation assay at a regional US Department of Veteran Affairs Medical Center. HIV screening tests performed by the laboratory from March 1, 2016 to February 28, 2017, prior to implementation of the new assay were compared with fourth-generation HIV screening tests performed from March 1, 2017 to February 28, 2018. Of 7,516 third-generation HIV screening tests reviewed, 52 were reactive on the screening assay; 24 were true positives, 28 were false positives. The following year 7,802 fourth-generation HIV screening tests were performed and 23 were reactive on the screening assay; 16 were true positives and 7 were false positives. The positive predictive value for the third-generation test was 46% and 70% for the fourth-generation test. There were fewer false-positive results with testing with the more specific fourth- vs third-generation assay (0.09% vs 0.37%, respectively), which was statistically significant (
Sections du résumé
BACKGROUND
BACKGROUND
In 2006, the Centers for Disease Control and Prevention issued guidelines advocating routine HIV screening for all patients. However, false-positive results are a potential patient care threat for low-risk populations even with accurate screening assays. A reduction in HIV false-positive screening results can potentially be seen by switching from the third-generation to a more sensitive and specific fourth-generation screening assay.
METHODS
METHODS
We studied the impact on the false-positive screening rate of a change to a fourth-generation assay at a regional US Department of Veteran Affairs Medical Center. HIV screening tests performed by the laboratory from March 1, 2016 to February 28, 2017, prior to implementation of the new assay were compared with fourth-generation HIV screening tests performed from March 1, 2017 to February 28, 2018.
RESULTS
RESULTS
Of 7,516 third-generation HIV screening tests reviewed, 52 were reactive on the screening assay; 24 were true positives, 28 were false positives. The following year 7,802 fourth-generation HIV screening tests were performed and 23 were reactive on the screening assay; 16 were true positives and 7 were false positives. The positive predictive value for the third-generation test was 46% and 70% for the fourth-generation test.
CONCLUSIONS
CONCLUSIONS
There were fewer false-positive results with testing with the more specific fourth- vs third-generation assay (0.09% vs 0.37%, respectively), which was statistically significant (
Identifiants
pubmed: 34177233
doi: 10.12788/fp.0125
pii: fp-38-5-232
pmc: PMC8221825
doi:
Types de publication
Journal Article
Langues
eng
Pagination
232-237Informations de copyright
Copyright © 2021 Frontline Medical Communications Inc., Parsippany, NJ, USA.
Déclaration de conflit d'intérêts
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
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