TITLE:
Performance Characteristics of Urine HIV Screening Methods against Blood-Based Methods for Surgeons Guide
AUTHORS:
M. W. Isichei, T. T. Selowo, D. Meshak, A. F. Ale, S. D. Peter, M. A. Misauno, A. Affi, O. Olaniru, C. O. Isichei
KEYWORDS:
HIV, AIDS, Sensitivity, Specificity, HIV Rapid Testing
JOURNAL NAME:
World Journal of AIDS,
Vol.10 No.2,
June
8,
2020
ABSTRACT: Testing
for Human Immunodeficiency Virus (HIV), widely distributed in sub-Saharan
Africa since it is mainly invasive but, could be non-invasive and quick also,
reducing waiting time especially when required for presurgical procedures. This
study determined the HIV status of patients using Urine screening test method
and to compare its performance to blood-based testing methods. The routine pre
and post-test counselling for HIV screening were done for all
provider-initiated HIV testing using blood-based screening methods. Due to the
cost and unavailability of enough urine testing kits, only patients who tested
positive for HIV with blood-based methods and were scheduled for surgery or a surgical procedure were
enrolled in the study. Informed consent was obtained. Paired urine and blood
samples were collected at the same visit into clean universal bottles and
analyzed immediately. A colloidal gold enhanced rapid immuno-chromatographic
assay (Alliance Biomedical) kit for the rapid qualitative detection of
antibodies to Human Immunodeficiency Virus (HIV) I and II in urine were used in
comparison to the standard HIV testing of ante-cubital venous blood collected
in EDTA vacutainer and analyzed using Determine (T) HIV 1 and 2 in vitro qualitative immunoassay strip,
UNI GOLD rapid test kit and the Chembio HIV 1/2 STAT PAK assay strip. A total
of 7568 patients were tested for routine provider-initiated HIV testing, 521
tested HIV positive. There were 105 (20.15%) males and 416 (79.85%) females,
age ranged from 15 years
to >80 years.
Most of the surgeries performed were Caesarian section 93 (37%), Hernia 55 (22%),
Lumps 48 (19%), Acute
appendicitis 33 (13%), Uterine
fibroids 10 (4%), Ruptured
ectopic pregnancy 2 (1%)
and others (Intestinal obstruction, Postoperative adhesions, Ingrown toe nails,
Breast abscess, Hemorrhoids, Anal fissures etc.) 10 (4%).
DETERMINE RAPID HIV TEST METHOD USING BLOOD: A total of 521 HIV positive
samples were tested, 502 (96.35%) tested HIV positive and 19 (3.65%) tested HIV
negative. These 19 HIV negatives were re-tested with Stak Pak: 19 (100%) tested
HIV positive. UNI GOLD HIV TEST METHOD USING BLOOD: A total of 521 HIV positive
samples were tested, 521 (100%) tested HIV positive. URINE TESTING METHOD: A total
of 251 (48.18%) of the 521 HIV positive patients were scheduled to undergo a
surgical procedure. These were re-tested using the Urine testing method, 235 (93.63%)
tested HIV positive while 16 (6.37%) tested negative. The blood sample of the
16 who tested negative using the Urine testing method was subjected to
confirmatory test using Stat Pak and all 16 (100%) tested HIV positive. The
specificity for Unigold and Determine blood testing was 100%. All three tests
had a Positive Predictive Value (PPV) of 100% while the Negative Predictive
Values (NPV) were 100% and 99.73% for Unigold and Determine respectively. The
use of Urine HIV testing method compared well to the blood HIV testing methods
and could be a better non-invasive sample method for screening of HIV/AIDS in the
population especially among surgeons’ pre-surgical procedures.