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Low specificity of HIV-testing on sputum specimens kept at ambient temperatures for 4 to 7 days: a blinded comparison

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dc.contributor.author Egwaga, S.M
dc.contributor.author Chonde, T.M
dc.contributor.author Matee, M.I
dc.contributor.author Mfinanga, S.G
dc.contributor.author Ngowi, P.E
dc.contributor.author Lwilla, F.
dc.contributor.author Cobelens, F.G.J.
dc.date.accessioned 2013-02-13T13:17:34Z
dc.date.available 2013-02-13T13:17:34Z
dc.date.issued 2007
dc.identifier.citation Egwaga, S. M., Chonde, T. M., Matee, M. I., Mfinanga, S. G., Ngowi, P. E., Lwilla, F., & Cobelens, F. G. (2007). Low specificity of HIV-testing on sputum specimens kept at ambient temperatures for 4 to 7 days: a blinded comparison. BMC clinical pathology, 7(1), 8.
dc.identifier.issn 1472-6890-7-8
dc.identifier.other doi:10.1186/1472-6890-7-8
dc.identifier.uri http://hdl.handle.net/123456789/415
dc.description.abstract Background: HIV testing on sputum using the QraQuick HIV1/2® assay has high sensitivity and specificity, and holds promise for application in tuberculosis surveys. Its performance under conditions that may occur during surveys in resource-poor countries is however, unknown. We assessed, in a blinded comparison with HIV serum testing, the sensitivity and specificity of the OraQuick® assay for detecting HIV antibody in sputum specimens kept at ambient temperature for up to 7 days, with and without decontaminant. Methods: Paired sputum and blood specimens from consecutively diagnosed smear-positive tuberculosis patients were tested with OraQuick® and 2 HIV-1/2 ELISA's. Sputum was tested within 24 hours of collection, split into 2 aliquots with and without addition of cetylpyridium chloride, and tested again after 4 and 7 days. Results: Complete data was available for 377/435 (87%) enrolled patients; 132 (35%) tested HIV positive on serum. The sensitivity of the sputum test was 94.7% (95% CI 89.4–97.8) on day 1, 93.2% on day 4 and 92.9% on day 7. The specificity was 92.9% (95% CI 88.9–95.8) on day 1, and declined to 76.7% on day 4 (p < 0.001) and to 62.7% on day 7 (p < 0.001). Adding cetylpyridium chloride further decreased the specificity to 67.8% on day 4 (p = 0.04) and to 49.6% on day 7 (p = 0.004). Conclusion: Transportation of sputum specimens at ambient temperatures for 4 days or more, and addition of decontaminant, strongly affect the specificity of the OraQuick® assay. Unless applied within one day, this assay is not suitable for estimation of HIV-prevalence among tuberculosis patients in survey settings. en_GB
dc.language.iso en en_GB
dc.publisher BioMed Central en_GB
dc.relation.ispartofseries BMC Clinical Pathology.7:8
dc.subject HIV-testing en_GB
dc.subject sputum en_GB
dc.subject ambient en_GB
dc.title Low specificity of HIV-testing on sputum specimens kept at ambient temperatures for 4 to 7 days: a blinded comparison en_GB
dc.type Article en_GB


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