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Research Article

JCR. 2020; 7(5): 2559-2567


A BAYESIAN META-ANALYSIS ON ACCURACY ESTIMATION OF FOURTH GENERATION HIV RAPID TESTS IN ACUTE HIV DIAGNOSIS

Cheemarla Vinay, Pooja Arora, Prasad V. Bharatam.

Abstract
Background
The purpose of this study is to estimate the diagnostic performance of fourth generation rapid test “Determine HIV 1/2
Ag/Ab Combo” and its reformulated version “Alere HIV Combo” in detecting acute HIV infections.
Methods
PubMed and Cochrane databases were searched with the combination of different key words using Boolean operators.
Quadas-2 tool was used for assessing the quality of the methodology and to identify the bias in the studies. Sensitivity
and specificity estimates were pooled using Bivariate Bayesian normal model. Finally, subgroup analysis was
performed.
Results
Overall, pooled sensitivity of Determine Combo was 77.4% (95% CI 51.7-93.1) and specificity was 99.1% (95% CI
98.3-99.5). The pooled sensitivity and specificity were 24.7% (95% CI 33-60.1) and 99.7% (95% CI 98-100)
respectively for antigen component and the pooled sensitivity and specificity was 78.9% (95% CI 56.2-93.0) and
99.2% (95% CI 98.5-99.6) respectively for antibody component. The overall pooled sensitivity and specificity was
80.5% (95% CI 51.6.4-96.6) and 98.3% (95% CI 95.4-100.0) respectively for reformulated HIV Combo.
Conclusions
Alere HIV combo has better diagnostic performance in detecting acute HIV infections when compared to Determine
combo. Effect of Viral RNA count and p24 antigen level on the diagnostic performances of these two tests must be
monitored in the future studies.

Key words: Determine Combo, HIV Combo, Bivariate Bayesian normal model, Acute HIV diagnosis



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