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Revised recommendations for the selection and use of HIV antibody tests

Ноябрь 14, 2016

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Recommendations for the selection and use of HIV antibody tests were first issued by WHO in 1992.1 Since then the range of HIV antibody tests available has expanded. New types of assays have been developed and the overall quality has improved. HIV tests for other body fluids (saliva and urine) have been developed. However, the testing strategies described here should only be applied to tests using serum or plasma.

To serve the needs of blood transfusion services, which use the vast majority of all HIV tests worldwide, increasingly sensitive HIV antibody assays have been developed in order to shorten the window period (the interval between the point of infection and the development of detectable antibody).

As a result of this trend, less sensitive but highly specific HIV tests have been withdrawn from the market. This is unfortunate as these were ideal as second and third line tests; their withdrawal affects the practical implementation of the proposed WHO HIV testing strategies. Choice of a testing strategy, the selection of the most appropriate test or combination of tests to use, depends on
3 criteria:

  • the objective of the test;
  • the sensitivity and specificity of the test(s) being used;
  • the prevalence of HIV infection in the population being tested.
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