Why wait? HIV tests now give immediate results
Rapid HIV tests, which allow you to get your HIV test result within a few minutes, should be in use country-wide within the course of next year. But only those rapid tests used in government health facilities have been properly evaluated for reliability. Quality control of the other brands on the market is not yet assured. Jo Stein reports
The rapid HIV test means that you can now get your HIV test result after a few minutes, and the test can be done in areas where laboratory facilities are not available.
The two rapid tests used by government facilities have been evaluated for reliability by the National Institute for Virology, which has declared them to be accurate and reliable enough to be used instead of HIV tests that require laboratory analysis.
This means that people at public health facilities, who in the past have had to wait at least a week for their results, will be able to get the same day. This will overcome the huge problem of patients not returning for their HIV results.
In addition, the public sector pays about R10, whereas the routine laboratory ELIZA test costs about R40 a test.
But the main advantage of the rapid test is that it can be used in rural health clinics as no laboratory or refrigeration is required to analyse results or store blood.
Dr Harry Hausler, technical advisor to the National Directorate on HIV/AIDS and STDs, says the rapid tests are already in use at four pilot sites around the country.
In Bushbuckridge, for example, only 10 percent of people who were tested for HIV ever actually got informed of their results. With the introduction of the rapid test, everyone now receives their results because they don’t have to travel home and come all the way back a week later. It’s easier and less expensive for both staff and clients, says Dr Hausler.
According to Dr Hausler, the tests should be in use country-wide within the first few months of next year.
The Western Cape is keen to make rapid tests standard at all its voluntary testing and counselling sites, and the AIDS Training and Information Centre (ATTIC) will start to train clinics in the use of rapid blood tests from early next year, according to ATTIC’s Cape Town manager Carol Jacobs.
However, as the rapid tests are so fast and easy to process, some concerns have been raised about the potential for them to be abused.
Dr Ashraf Grimwood, chairperson of the National AIDS Council of SA, says that without proper controls, employers could purchase the tests and use them.
“Rapid tests, like any HIV tests, should only be done with pre and post-test counselling and informed consent,” cautions Dr Des Martin, head of the South African HIV Clinician’s Society.
Aside from the blood-based rapid tests, research published in the latest South African Medical Journal (SAMJ) shows that saliva-based rapid tests are also becoming highly accurate, although they are not yet completely fool-proof.
The advantage of saliva specimens is that they are even easier to collect than blood specimens, and tests can be conducted by “non-skilled personnel”, says Dr Lynne Webber, Senior Specialist in Clinical Virology at the University of Pretoria.
The saliva testing kit requires that a collector pad be placed under the tongue until an indicator stalk turns blue, which can take up to six minutes. The pad must then be placed immediately inside a buffer tube.
While Dr Webber’s research suggests that saliva tests are fast approaching the accuracy levels of blood tests, saliva tests will not be recommended for use in South Africa until they are endorsed by the World Health Organization (WHO), says Dr Martin.
So far, the WHO has endorsed the use of rapid blood tests but not the use of rapid saliva or urine tests on the grounds that these may still produce false negative results.
All HIV test results that give a positive result are routinely checked with at least one other kind of test for accuracy. However, tests which show up negative are not double-checked so saliva or urine tests, which occasionally give false negative results, are not considered reliable.
The National Department of Health warns the public against purchasing rapid HIV tests of any kind from pharmacies on the grounds that HIV testing should always be accompanied by pre and post-test counselling and because quality control of all the brands on the market is not yet assured.
“We still haven’t evaluated them all rigorously and put together a list of the best tests,” says Dr Grimwood. -Health-e News.