Performance of HIV rapid testing algorithm in Nigeria: Findings from a household-based Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS)

• DOI: 10.1371/journal.pgph.0000466
• Publication Date: 2022-07-29T17:24:16Z
• Authors: Hetal K. Patel; Sunday Ikpe; Megan Bronson; Sehin Birhanu; Alash’le Abimiku; Ibrahim Jahun; Mervi Detorio; Kathryn Lupoli; Daniel Yavo; Orji O. Bassey; Tapdiyel D. Jelpe; Brian Kagurusi; Nnaemeka C. Iriem...; Divya Patel; McPaul I. Okoye; Ibrahim T. Dalhatu; Stephen Ohakanu; Andrew C. Voetsch; Sani Aliyu; Gregory Ashefor; Aliyu Gambo; Gabriel O. Ikwulono; Charles Nzelu; Isaac F. Adewole; Mahesh Swaminathan; Bharat Parekh
• Keywords: Concordance; HIV screening; Hiv test

Background The Nigeria AIDS Indicator and Impact Survey (NAIIS), a cross-sectional household survey, was conducted in 2018 with primary objectives to estimate HIV prevalence, HIV-1 incidence, status of UNAIDS 90-90-90 cascade. We retrospective analysis the performance rapid tests national testing algorithm used Nigeria. Methods included Determine HIV-1/2 as test 1 (T1), Unigold 2 (T2), StatPak tie-breaker (T3). Individuals reactive T1 either T2 or T3 were considered HIV-positive. HIV-positive specimens from further confirmed for survey using supplemental Geenius HIV-1/2. If did not confirm status, Western blot performed. calculated concordance between positive predictive value (PPV) on unweighted data. Results Of 204,930 participants (ages ≥18 months) 5,103 (2.5%) T1. Serial if needed by tiebreaker identified 2958 (1.44%) persons Supplemental 2,800 (95%) (HIV-1 = 2,767 [98.8%]; HIV-2 5 [0.2%]; dual infections 22 [0.8%]). Concordance 56.6% while PPV 94.5%. Conclusions Our results show high discordant rates poor false-positive rate about 5.5% NAIIS survey. Considering our findings have major implications diagnosis routine services, additional evaluation is warranted