A Comparative Analysis of the different HIV Testing Techniques used in Zambia: Data from a Clinical Performance Study

Abstract Objective Early detection of HIV means early identification of people living with HIV, who are immediately linked to care and antiretroviral therapy. This decreases transmission of the virus, which reduces HIV new infection rates. The aim of the study was to investigate the effectiveness of different HIV testing strategies used in Zambia. Results A quantitative descriptive approach was used to analyze samples of 2564 participants within Lusaka district. 2564 participants were subjected to OraQuick ADVANCE Rapid HIV-1/2 Antibody Test and Abbot Determine™ HIV-1/2 antibody test, if Reactive, they were tested on Uni-Gold™ Recombigen® HIV-1/2 rapid test as a confirmatory RDT. The samples sent to the Laboratory were tested on fourth generation Abbot ARCHITECT HIV Ag/Ab Combo and then confirmed on Genscreen™ ULTRA HIV Ag-Ab. The Abbot ARCHITECT HIV Ag/Ab Combo fourth generation assay was used as the gold standard to compare the other tests. OraQuick ADVANCE Rapid HIV-1/2 Antibody Test detected 245 reactive tests, Abbot Determine™ HIV-1/2 antibody test detected 249 reactive tests, all reactive tests on the first two RDTs were confirmed on Uni-Gold™ Recombigen® HIV-1/2 rapid test which detected 247 Reactive and 2 Non-Reactive. The fourth generation reference test -ARCHITECT HIV Ag/Ab Combo detected 2297 Non-Reactive and 267 Reactive tests. Conclusion The results indicate that the rapid tests false negatives are high and a 4th generation Rapid test to the testing algorithm is vital. This will increase total number of Positive results being missed be accounted for.