Hepatitis B virus surface antigen and anti-hepatitis C virus rapid tests underestimate hepatitis prevalence among HIV-infected patients.
OBJECTIVE
In the case of coinfection with HIV and hepatitis B virus (HBV) and/or hepatitis C virus (HCV), hepatic disease progression is often accelerated, with higher rates of liver cirrhosis and liver-related mortality. We aimed to evaluate the performance of the rapid tests used routinely to detect HBV surface antigen (HBsAg) and anti-HCV among HIV-infected patients in Guinea-Bissau.


METHODS
Blood samples from HIV-infected patients in Guinea-Bissau were stored after testing for HBsAg and anti-HCV with rapid tests. Samples were subsequently re-tested for HBsAg and anti-HCV in Denmark.


RESULTS
Two rapid tests were used in Guinea-Bissau: HBsAg Strip Ref 2034 (VEDA.LAB, Alençon, France; sensitivity 62.3%; specificity 99.2%) and HEPA-SCAN (Bhat Bio-Tech, Bangalore, India; sensitivity 57.1%; specificity 99.7%). In the two tests the ability to obtain the correct outcome depended on the antigen and antibody concentrations, respectively. Sex, age, CD4 cell count and antiretroviral therapy status did not differ between false negative and true positive samples in either of the tests. The study is limited by a low number of anti-HCV positive samples.


CONCLUSIONS
New diagnostic rapid tests should always be evaluated in the setting in which they will be used before implementation.
The Bandim Health Project, Indepth Network, Bissau, Guinea-Bissau; Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark.
Bl
B
Hønge
S
S
Jespersen
C
C
Medina
Ds
D
Té
Zj
Z
da Silva
L
L
Ostergaard
Al
A
Laursen
C
C
Wejse
H
H
Krarup
C
C
Erikstrup
D019380:Anti-HIV Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D018450:Disease Progression; D006169:Guinea-Bissau / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology; D006509:Hepatitis B / Q000453:epidemiology* / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology; D006526:Hepatitis C / Q000453:epidemiology* / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000097:blood* / Q000276:immunology; D006801:Humans; D008099:Liver / Q000276:immunology / Q000473:pathology*; D015995:Prevalence; D012680:Sensitivity and Specificity
D019380:Anti-HIV Agents; D015415:Biomarkers; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies
Guinea-Bissau; HIV; anti-hepatitis C virus; hepatitis B virus surface antigen; rapid tests