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  • Title: Human immunodeficiency virus (HIV) antigen testing to detect HIV infection in female sex workers in Singapore.
    Author: Chan RK, Ali K, Thoe SY.
    Journal: Ann Acad Med Singap; 1995 Jul; 24(4):534-6. PubMed ID: 8849183.
    Abstract:
    Human immunodeficiency virus (HIV) infection is characterised by seroconversion after a ¿window¿ period of 2 to 3 months. After this period antibodies are usually detectable by screening tests (enzyme immunoassay or particle agglutination) confirmed by Western blot analysis. We studied 1000 newly enrolled female sex workers who had not been previously tested for HIV to assess the usefulness of HIV antigen testing to improve the efficacy of HIV infection detection. Blood was taken at enrollment for HIV antigen and HIV antibody testing. The Abbott HIVAG-1 test was used to detect antigen; antibody detection was by the Abbott recombinant HIV-1/HIV-2 3rd generation enzyme immunoassay (EIA) test, the Fujirebio Serodia-HIV particle agglutination (PA) test for screening, and the Diagnostic Biotechnology HIV Blot 2.2 Western blot (WB) test for antibody confirmation. Of the 1000 samples, 26 were positive for HIV antibody testing (26/26 for EIA, 25/25 for PA, 26/26 for WB), giving a prevalence rate of 2.6%, Of these 26 seropositive samples 1 was positive on HIV antigen testing. There were no samples which were antigen-positive and antibody-negative. HIV antigen testing does not add to increased efficacy of HIV detection among female sex workers in Singapore. Since the HIV p24 antigen appears a few weeks before the HIV antibody, researchers conducted a study to determine whether the HIV antigen test Abbott HIV AG-1 would identify recently HIV-infected female sex workers in Singapore whose infection might be missed if only HIV antibody tests were used. During April 1993-April 1994, blood samples were taken from 1000 female sex workers newly enrolled in the Department of STD (sexually transmitted disease) Control of Singapore General Hospital to test for the HIV p24 antigen. Results of the Abbott HIV AG-1 test were compared with 3 HIV antibody tests (Abbott recombinant HIV-1/HIV-2 3rd generation enzyme immunoassay [EIA] test, the Fujirebio Serodia-HIV particle agglutination [PA] test, and the Diagnostic Biotechnology HIV Blot 2.2 Western blot [WB] test). All 3 HIV antibody tests found 25 female prostitutes to be HIV positive. The EIA and WB tests found 26 women to be HIV positive for a prevalence rate of 2.6%. Only 1 specimen tested positive for HIV antigen. This specimen also tested positive for HIV antibodies. There was no HIV antigen positive specimen that was HIV antibody negative or indeterminate. These findings show that the HIV antigen test did not improve the detection rate of HIV infection in these female sex workers, since there were no HIV antigen specimens that were HIV antibody negative or indeterminate.
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