IS POINT-OF-CARE TESTING A USEFULTOOL FOR THE PREVENTION OF HIVINFECTIONS?Tomislav Rukavina, MD, PhDVanja Vasiljev Marches...
Point-of-care testing (POCT) is defined asmedical testing near the site of patient. It givesrapid results and allows immed...
HIVAt the end of 2010. an estimated:34 million people globally living with HIV2.7 million new HIV infections in 20101.8 mi...
STANDARD HIV DIAGNOSIS                very sensitive test for detection   ELISA        of antibodies to HIV antigens in   ...
ELISA                            Western blotnegative           positive                              confirm             ...
Advantages                Disadvateges the mere presence        false       negativeof       antibody    is   results du...
POCT HIV DIAGNOSIS             Six tests were approved by FDA in             USA:                    1. Clearview COMPLETE...
WHEN TO USE HIV POCT For patients who are difficult to reach (MSM  population, drug abusers) In regions with poor labora...
WHEN TO USE HIV POCT    Urgent decisions to be             made: management of transmission of HIV from motherto child du...
BASIC PRINCIPLE OF POCT HIV DIAGNOSIS          Immunocromatography                 assay sample: blood, plasma, serum or ...
Diagram of the physical and functional       components of the Efoora HIV rapid test.Arens M Q et al. J. Clin. Microbiol. ...
POCT HIV DISADVANTAGES false negative results withinseroconversion period (with aseroconversion panel, some tests detecte...
CONCLUSIONS POCT HIV gives quick preliminary results(some within 20 minutes) Rapid diagnosis enables a immediatetreatmen...
CONCLUSIONS Most tests allows storing in roomtemperature - suitable for transport and storagein inappropriate environment...
rukavina tomislav - point-of-care testing
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rukavina tomislav - point-of-care testing

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6th Regional Conference in Sarajevo, May 17-18 2012.

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rukavina tomislav - point-of-care testing

  1. 1. IS POINT-OF-CARE TESTING A USEFULTOOL FOR THE PREVENTION OF HIVINFECTIONS?Tomislav Rukavina, MD, PhDVanja Vasiljev Marchesi, MSE, PhDDepartment of Social Medicine and EpidemiologyUniversity of RijekaCroatia
  2. 2. Point-of-care testing (POCT) is defined asmedical testing near the site of patient. It givesrapid results and allows immediate medicaldecisions. HIV screening of all adults, adolescents and pregnant women is cost-effective as screening for breast and colon cancer (CDC)
  3. 3. HIVAt the end of 2010. an estimated:34 million people globally living with HIV2.7 million new HIV infections in 20101.8 million people died of AIDS-related illnesses Republic of Croatia in 2011. had 943 diagnosed HIV infection (2010. 862 HIV positive patients)
  4. 4. STANDARD HIV DIAGNOSIS very sensitive test for detection ELISA of antibodies to HIV antigens in serum or plasma detects the envelope HIV Western blot proteins in patient serum or plasma used to confirm ELISA test detects the viral RNA/DNA from PCR samples
  5. 5. ELISA Western blotnegative positive confirm HIV-1 Western Blot  Lane1: Positive Control  Lane 2: Negative Control  Sample A: Negative  Sample B: Indeterminate  Sample C: Positive
  6. 6. Advantages Disadvateges the mere presence  false negativeof antibody is results during thesufficient to make a period ofdefinitive diagnosis seroconversion (2 weeks to 3 months)  require laboratory and experienced medical stuff
  7. 7. POCT HIV DIAGNOSIS Six tests were approved by FDA in USA: 1. Clearview COMPLETE 2. Clearview STAT-PAK 3. OraQuick Advance HIV- Rapid HIV tests 1/2 4. Multispot HIV-1/2 5. Reveal G3 6. Uni-Gold Recombigen
  8. 8. WHEN TO USE HIV POCT For patients who are difficult to reach (MSM population, drug abusers) In regions with poor laboratory access Must include pre- and post- counselling
  9. 9. WHEN TO USE HIV POCT Urgent decisions to be made: management of transmission of HIV from motherto child during pregnancy and/or delivery for prophylaxis of exposed person to infectedblood or body fluids for infected patients with specificmicroorganisms (Pneumocystis jiroveciipneumonia) high risk clients POC testing of HIV is not designed for screening the general population!!!!
  10. 10. BASIC PRINCIPLE OF POCT HIV DIAGNOSIS Immunocromatography assay sample: blood, plasma, serum or oral fluid tests contains HIV-1 and/or HIV-2 antigensand detects antibodies to HIV antigens
  11. 11. Diagram of the physical and functional components of the Efoora HIV rapid test.Arens M Q et al. J. Clin. Microbiol. 2005;43:2399-2406
  12. 12. POCT HIV DISADVANTAGES false negative results withinseroconversion period (with aseroconversion panel, some tests detectedHIV about 3 days later than the mostsensitive HIV antibody-only EIA tests) increasing risk of false positive results inlow prevalence population
  13. 13. CONCLUSIONS POCT HIV gives quick preliminary results(some within 20 minutes) Rapid diagnosis enables a immediatetreatment decisions Rapid diagnosis reduces the possibility ofspreading of virus
  14. 14. CONCLUSIONS Most tests allows storing in roomtemperature - suitable for transport and storagein inappropriate environments Best option for difficult to reach population POCT HIV is good choice for areas with poorlaboratory diagnostic

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