Indian Journal of Sexually Transmitted Diseases and AIDS
ORIGINAL ARTICLE
Year
: 2019  |  Volume : 40  |  Issue : 2  |  Page : 126--132

Extensive tests for extermination: Need for incorporation of molecular detection methods of human immunodeficiency virus in screening algorithm in tertiary hospitals in India


Priya Singh1, Ruchita Tyagi2, Surjit Singh3, Aman Sharma4, Ritu Aggarwal5, Ranjana W Minz5 
1 Department of Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
3 Department of Pediatrics Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
4 Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
5 Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Prof. Ranjana W Minz
Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh - 160 012
India

Context: A downward trend is being observed in the incidence of human immunodeficiency virus (HIV) infection in India due to strategic activities of National AIDS Control Organisation (NACO) in the last 24 years. Opt-out testing has consistently shown high seroprevalence in our tertiary care center. Aim: This study aims to audit opt-out testing and compare various commercial test kits used to detect HIV seroprevalence in patients in our tertiary care institute and suggest new algorithm for HIV testing in tertiary hospitals in India. Materials and Methods: Retrospective analysis of 30,021 samples tested in Department of Immunopathology using opt-out testing delinked from the NACO-sponsored testing for Integrated Counselling and Testing Centre (ICTC) was performed. Study population comprised of presurgery and emergency patients which at the time of our reporting were not included in ICTC testing. Results: Microlisa was the first test performed on 76% samples. 1.02% cases were reactive only with Microlisa and negative with other rapid kits hence were reported as negative, according to NACO scheme of reporting. Advanced testing algorithm followed by centre for disease control (CDC) showed that 80% of these 4th-generation positive and rapid test-negative patients turned out to be acute HIV infections on molecular testing. Conclusion: Patients in tertiary referral center constitute high-risk population and should be screened with 4th-generation enzyme-linked immunosorbent assay which incorporates p24 antigen. Those which are found indeterminate should have molecular testing by nucleic acid amplification test or real-time polymerase chain reaction, as our study has demonstrated that 1.02% of these cases may harbor acute HIV infection.


How to cite this article:
Singh P, Tyagi R, Singh S, Sharma A, Aggarwal R, Minz RW. Extensive tests for extermination: Need for incorporation of molecular detection methods of human immunodeficiency virus in screening algorithm in tertiary hospitals in India.Indian J Sex Transm Dis 2019;40:126-132


How to cite this URL:
Singh P, Tyagi R, Singh S, Sharma A, Aggarwal R, Minz RW. Extensive tests for extermination: Need for incorporation of molecular detection methods of human immunodeficiency virus in screening algorithm in tertiary hospitals in India. Indian J Sex Transm Dis [serial online] 2019 [cited 2020 Jan 22 ];40:126-132
Available from: http://www.ijstd.org/article.asp?issn=2589-0557;year=2019;volume=40;issue=2;spage=126;epage=132;aulast=Singh;type=0