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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update

CANADA: Head-to-Head Comparison of Accuracy of a Rapid Point- of-Care HIV Test with Oral Versus Whole-Blood Specimens: A Systematic Review and Meta-Analysis


Lancet Infectious Diseases doi:10.1016/S1473-3099(11)70368-1

In the current study, the researchers sought to establish whether a convenient, non-invasive HIV test that uses oral fluid was accurate compared with using the same test with blood-based specimens.

The systematic review and meta-analysis compared the accuracy of OraQuick Advance Rapid HIV-1/2 test using oral fluid versus blood-based specimens among adults at risk of HIV. The study authors searched five databases of published work and databases of five key HIV conferences. Diagnostic accuracy was assessed with bivariate regression analysis, and positive predictive values (PPVs) in high- and low-prevalence settings were computed with Bayesian methods.

In a direct comparison of studies, the researchers identified a pooled sensitivity about 2 percent lower in oral (98.03 percent, 95 percent CI 95.85-99.08) than in blood-based specimens (99.68 percent, 97.31-99.96), but similar specificity (oral 99.74 percent, 99.47-99.88; blood 99.91 percent, 99.84-99.95). Negative likelihood ratios were small and similar (oral 0.019, 0.009-0.040; blood 0.003, 0.001- 0.034), but positive likelihood ratios differed (oral 383.37, 183.87-799.31; blood 1105.16, 633.14-2004.37). Although in high-prevalence settings PPVs were similar (oral 98.65 percent, 95 credible interval 85.71-99.94; blood 98.50, 93.10- 99.79), in low-prevalence settings PPVs were lower for oral (88.55 percent, 77.31-95.87) than blood (97.65 percent, 95.48- 99.09) specimens.

"Although OraQuick had a high PPV in high-prevalence settings in oral specimens, the slightly lower sensitivity and PPV in low-prevalence settings in oral specimens should be carefully reviewed when planning worldwide expanded initiatives with this popular test," concluded Pant Pai and colleagues.


Copyright © 2012 -CDC Prevention News Update, Publisher. All rights reserved to Information, Inc., Bethesda, MD. The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

Information in this article was accurate in February 3, 2012. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.