Longitudinal patterns in indeterminate HIV rapid antibody test results: a population-based, prospective cohort study

• DOI: 10.1128/spectrum.03253-23
• Publication Date: 2024-01-08T14:01:09Z
• Authors: Joanne H. Hunt; George Mwinnyaa; Eshan U. Patel; M. Kate Grabowski; Joseph Kagaayi; Ronald H. Gray; Joseph Ssekasanvu; Maria J. Wawer; Godfrey Kigozi; Larry W. Chang; Sarah Kalibbala; Margaret Nakalanzi; Anthony Ndyanabo; Thomas C. Quinn; David Serwadda; Steven J. Reynolds; Ronald M. Galiwango; Oliver Laeyendecker
• Keywords: Indeterminate

Rapid HIV tests are critical to surveillance and universal testing treatment programs. We assessed longitudinal patterns in indeterminate rapid test results an African population-based cohort. Prospective antibody results, defined by two parallel tests, among participants aged 15-49 years from three survey rounds of the Rakai Community Cohort Study, Uganda, 2013 2018, were assessed. An result was as any weak positive or when one negative other positive. A total 31,405 contributed 54,459 person-visits, with 15,713 contributing multiple visits 7,351 3 visits. The prevalence 2.7% (1,490/54,469). Of who initially tested (n = 591), 40.4% negative, 18.6% positive, 41.0% at subsequent visit. consecutive had a third visit 67), 20.9% 9.0% 70.2% remained indeterminate. Compared prior result, strongly associated [adjusted ratio, 23.0 (95% CI 20.0-26.5)]. men, women more likely than odds 2.3 2.0-2.6)]. Indeterminate highly correlated within individual 0.6% population persistently over study period. substantial fraction people subsequently next visit, underscoring importance follow-up protocols.IMPORTANCERapid tool for expanding end epidemic. interpretation management pose unique challenge connecting all living necessary care treatment. characterized discordant (when is positive). systematically Ugandan population-based, cohort regardless status quantify results. found that (>15%) upon Our findings demonstrate protocols