Oral Fluid Rapid HIV Test Accuracy Questioned

Researchers identified two clusters of increased false-positive results in New York City

FRIDAY, June 20 (HealthDay News) -- Oral fluid testing with the OraQuick Advance Rapid HIV-1/2 Antibody Test is associated with episodic increases in the number of false-positive results, according to a report published in the June 20 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Julia Cummiskey, of the New York City Department of Health and Mental Hygiene (NYC DOHMH), and colleagues identified two clusters of increased false-positive oral fluid test results that occurred in late 2005, when the monthly number spiked from five to 36, and in late 2007 and early 2008, when the monthly number spiked from 23 to a high of 54.

After the first jump in false positives, the clinic began to follow reactive fluid tests with a second OraQuick test on finger-stick whole-blood specimens. They continued to do so after the second rise in false positives, although 550 patients with reactive oral fluid tests did not receive a finger-stick test.

"The cause for the episodic increases in false-positive oral fluid tests has not yet been determined," the authors write. "The NYC DOHMH has again suspended the use of oral fluid testing in STD clinics, and finger-stick whole-blood testing is the only rapid HIV test being used in this setting. These findings underscore the importance of confirming all reactive HIV tests, both from oral fluid and whole-blood specimens. In addition, the results suggest that the NYC DOHMH strategy of following-up reactive oral fluid test results with an immediate finger-stick whole-blood test reduced the number of apparent false-positive oral fluid test results and might be a useful strategy in other settings and locations."

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