@article{fdi:010048504,
  title = {{I}naccurate diagnosis of {HIV}-1 group {M} and {O} is a key challenge for ongoing universal access to antiretroviral treatment and {HIV} prevention in {C}ameroon},
  author = {{A}ghokeng {F}obang, {A}velin and {M}poudi-{N}gole, {E}. and {D}imodi, {H}. and {A}tem-{T}ambe, {A}. and {T}ongo, {M}. and {B}utel, {C}hristelle and {D}elaporte, {E}ric and {P}eeters, {M}artine},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {I}ncreased access to {HIV} testing is essential in working towards universal access to {HIV} prevention and treatment in resource-limited countries. {W}e here evaluated currently used {HIV} diagnostic tests and algorithms in {C}ameroon for their ability to correctly identify {HIV} infections. {M}ethods: {W}e estimated sensitivity, specificity, and positive and negative predictive values of 5 rapid/simple tests, of which 3 were used by the national program, and 2 fourth generation {ELISA}s. {T}he reference panel included 500 locally collected samples; 187 {HIV}-1 {M}, 10 {HIV}-1 {O}, 259 {HIV} negative and 44 {HIV} indeterminate plasmas. {R}esults: {N}one of the 5 rapid assays and only 1 {ELISA} reached the current {WHO}/{UNAIDS} recommendations on performance of {HIV} tests of at least 99% sensitivity and 98% specificity. {O}verall, sensitivities ranged between 94.1% and 100%, while specificities were 88.0% to 98.8%. {T}he combination of all assays generated up to 9% of samples with indeterminate {HIV} status, because they reacted discordantly with at least one of the different tests. {I}ncluding {HIV} indeterminate samples in test efficiency calculations significantly decreased specificities to a range from 77.9% to 98.0%. {F}inally, two rapid assays failed to detect all {HIV}-1 group {O} variants tested, with one rapid test detecting only 2 out of 10 group {O} specimens. {C}onclusion: {I}n the era of {ART} scaling-up in {A}frica, significant proportions of false positive but also false negative results are still observed with {HIV} screening tests commonly used in {A}frica, resulting in inadequate treatment and prevention strategies. {D}epending on tests or algorithms used, up to 6% of {HIV}-1 {M} and 80% of {HIV}-1 {O} infected patients in {C}ameroon do not receive {ART} and adequate counseling to prevent further transmission due to low sensitivities. {A}lso, the use of tests with low specificities could imply inclusion of up to 12% {HIV} negative people in {ART} programs and increase budgets in addition to inconveniences caused to patients.},
  keywords = {{CAMEROUN}},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {4},
  numero = {11},
  pages = {e7702},
  ISSN = {1932-6203},
  year = {2009},
  DOI = {10.1371/journal.pone.0007702},
  URL = {https://www.documentation.ird.fr/hor/fdi:010048504},
}