Exposure to HIV: When Laboratory Investigation Time is Gold

Abstract

To offer a rapid investigation on potential source of infection in case of worker exposure (needle stick) to reduce anxiety and to offer an accurate assessment we stressed the analytical performances of two commercial HIV point of Care (POCT). This strategy could suggest to give or not a retroviral therapy in less than 4 hours, the expected time to have the optimal infection’s prophylaxis. 60 selected serum samples were previously analyzed, confirmed and classified for HIV positivity/negativity by conventional laboratory procedure: HIV Combo Ag/Ab Abbott diagnostic®, USA; Western Blot Matrix HIV 1/2 Abbott®, USA. Suddenly we investigated all samples by the new POCT test (HIV 1/2 Ag/Ab Combo InvernessMedical®, Chiba Japan) 60 selected serum are classified 40 as negative and 20 as positive. We analyzed our data by quantify agreement with kappa (Choen’s kappa coefficient) and we registered a poor strength of agreement between two immunocromatographic HIV tests but a perfect strength of agreement (Kappa=1.000) between CMIA test and Immunocromatographic Ag/Ab HIV and PNV, VVP, sensitivity and specificity are 100%. All acute healthcare settings should expect to have an access to an urgent HIV screening assay result ideally within four hours, and definitely within 24 h, to provide optimal support for exposure incidents. POCT can give a rapidly diagnostic evaluation on a possible source of infection enabling to give an accurate indication for a prophilactic treatment.