title: Potential for false positive HIV test results with the serial rapid HIV testing algorithm.
abstract: BACKGROUND
  Rapid HIV tests provide same-day results and are widely used in HIV testing programs in areas with limited personnel and laboratory infrastructure. The Uganda Ministry of Health currently recommends the serial rapid testing algorithm with Determine, STAT-PAK, and Uni-Gold for diagnosis of HIV infection. Using this algorithm, individuals who test positive on Determine, negative to STAT-PAK and positive to Uni-Gold are reported as HIV positive. We conducted further testing on this subgroup of samples using qualitative DNA PCR to assess the potential for false positive tests in this situation.
  
  
  RESULTS
  Of the 3388 individuals who were tested, 984 were HIV positive on two consecutive tests, and 29 were considered positive by a tiebreaker (positive on Determine, negative on STAT-PAK, and positive on Uni-Gold). However, when the 29 samples were further tested using qualitative DNA PCR, 14 (48.2%) were HIV negative.
  
  
  CONCLUSIONS
  Although this study was not primarily designed to assess the validity of rapid HIV tests and thus only a subset of the samples were retested, the findings show a potential for false positive HIV results in the subset of individuals who test positive when a tiebreaker test is used in serial testing. These findings highlight a need for confirmatory testing for this category of individuals.
authors.affiliation: Department of Medicine, Makerere University School of Medicine, Kampala, Uganda. baveewosteven@yahoo.co.uk
authors.forename: Steven
authors.initials: S
authors.lastname: Baveewo
authors.forename: Moses R
authors.initials: MR
authors.lastname: Kamya
authors.forename: Harriet
authors.initials: H
authors.lastname: Mayanja-Kizza
authors.forename: Robin
authors.initials: R
authors.lastname: Fatch
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Coates
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
authors.forename: Rhoda K
authors.initials: RK
authors.lastname: Wanyenze
mesh_terms: D000328:Adult; D000465:Algorithms; D004279:DNA, Viral / Q000235:genetics; D005189:False Positive Reactions; D005260:Female; D006678:HIV / Q000235:genetics / Q000276:immunology; D015483:HIV Antibodies / Q000097:blood / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D025202:Molecular Diagnostic Techniques / Q000379:methods; D016133:Polymerase Chain Reaction; D011933:Reagent Kits, Diagnostic / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014454:Uganda; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D015483:HIV Antibodies; D011933:Reagent Kits, Diagnostic