AEGiS-11IAC: Evaluation of rapid on-site clinic HIV test (Capillus), combined with counselling.

11th International AIDS Conference

Vancouver, British Columbia — July 7-12, 1996

Evaluation of rapid on-site clinic HIV test (Capillus), combined with counselling.

Int Conf AIDS 1996 Jul 7-12; 11:445 (abstract no. Pub.B.1044)
Mashu A, Mbizvo MT, Makura E, Bopoto R, Madzime S, Chipato T, Fottrell P; Department of Obstetrics and Gynaecology, University of Zimbabwe Medical School, Harare, Zimbabwe. Fax: 263-4-663476, 263-4-724912. E-mail: EdMujeraathealthnet.ZW.

OBJECTIVE: To assess the performance of on-site rapid (5 minutes) HIV testing by nurses/midwives followed by confirmatory testing in the reference laboratory.

METHODS: 1168 women presenting for antenatal care (ANC) in four maternity clinics and 99 women in the postpartum from a nested vertical transmission cohort were tested for HIV at clinic sites with use of Capillus HIV-1/HIV-2 kit. Samples were further tested by Capillus, a Rapid Test Device (RTD), ELISA, and Western Blot in the laboratory. Pre-test counselling consisted of discussions on implications of the results, identification of clients family support systems, delivery of information and difference between AIDS/HIV and client empowerment to share and cope with the results. In post-test counselling results were given immediately followed by deliberate silence after which clients concerns, foreseeable difficulties, suitable solutions and HIV/AIDS support systems were identified and discussed.

RESULTS: The overall HIV prevalence in the ANC women by on-site Capillus was 29.3%, and that in the reference laboratory was 31.0% by Capillus, 29.8% by RTD, 30.6% by ELISA and 30.2% by Western Blot. Sensitivity of on-site Capillus HIV by nurses against Western Blot in the 1267 samples was 95.8%, the specificity was 99.7% and positive and negative predictive values were 95.8% and 98.1% respectively. Overall sensitivity and specificity pattern is shown in table 1 for the 1267 subjects. Results show that Capillus is a sensitive diagnostic tool in the rapid, on-site detection of HIV infection. (table: see text)

CONCLUSION: On-site HIV testing by nurses in clinic settings with use of Capillus provides a sensitive easy-to-use procedure which can be combined with on-site counselling. The high specificity, sensitivity and predictive values on both positive and negative samples indicate that this method is suitable for on-site HIV investigations especially where sophisticated equipment may not be available. Capillus on-site testing at the clinic offers performance characteristics comparable to the laboratory ELISA and should be considered as a cost effective rapid diagnostic tool in health care. The on site test has the benefit of enhancing health education among patients and better ways of coping with HIV/AIDS if they should be infected.

Keywords: AEGIS, Counseling, Evaluation Studies, HIV Infections, HIV-2, HIV-1, Mass Screening, Blotting, Western, Sensitivity and Specificity, Disease Transmission, Vertical, Ambulatory Care Facilities, Enzyme-Linked Immunosorbent Assay, Acquired Immunodeficiency Syndrome, Human, Female, nursing, transmission, ICA11

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PubB1044