High specificity of OraQuick (R) rapid HIV-1/2 antibody testing during dengue infection

Abstract

Background: OraQuick® is a rapid test with high specificity demonstrated in non-dengue endemic settings. However, reports of false positive OraQuick® results suggest poor specificity in the context of dengue fever. Objectives: To assess the specificity of OraQuick® for HIV-1/2 in patients with dengue fever. Study design: In a study performed across two Singapore hospitals, adult participants meeting WHO 2009 criteria for probable dengue (fever >37.5 °C plus two other clinical or haematological criteria) were identified at hospital outpatient clinics from April 2012 to July 2013. Eligible participants were asked for informed consent to complete a questionnaire on HIV risk factors, as well as HIV testing by OraQuick®, fourth-generation EIA and NAAT. Dengue testing was by Dengue Duo NS1Ag + Ab Combo kits. Confirmed dengue was defined as NS1-positive and probable dengue as IgM-positive. Results: Of 152 eligible patients, 82 consented to inclusion in the study. Fifty-two of these had dengue; 43 confirmed and 9 probable cases. All patients with dengue had a negative OraQuick® result, negative EIA and undetectable HIV-1 RNA, corresponding to a specificity of 100 %. Conclusions: OraQuick® has high specificity in the context of dengue infection. It can be used to diagnose HIV-associated illness as a cause of fever in dengue endemic settings.