Skip to main content
Log in

HIV serology signal-to-cutoff ratio as a rapid method to predict confirmation of HIV infection

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Early and rapid detection of patients with HIV is a key to preventing further transmission. The purpose of this study was to assess the ability of signal-to-cutoff (S/CO) ratio from initial screening fourth-generation HIV serology to predict subsequent confirmation of HIV. Patients with a first-time positive HIV serology (S/CO ratio ≥ 1) from 2012 to 2016 were included. Ratios were compared to the results of confirmatory testing. Predictive probabilities (PPs) of a positive confirmatory result were calculated based on a logistic regression model. A total of 45,138 HIV serology tests were performed; 250 patients met inclusion criteria, comprising 84 (34%) HIV negative patients, 136 (54%) chronic infections, and 30 (12%) acute infections. The PP of a confirmed positive result increased with higher S/CO ratios, with a PP of 100% for a S/CO of 55 (95% CI 95–100). This study enables a more informed discussion of the probability of HIV infection, based on HIV serology S/CO thresholds, prior to a confirmatory result.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gustafson R, Montaner J, Sibbald B (2012) Seek and treat to optimize HIV and AIDS prevention. CMAJ 184(18):1971

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hollingsworth TD, Anderson RM, Fraser C (2008) HIV-1 transmission, by stage of infection. J Infect Dis 198(5):687–693

    Article  PubMed  Google Scholar 

  3. (2014) Human immunodeficiency virus—HIV screening and testing guide. Available at: http://www.phac-aspc.gc.ca/aids-sida/guide/hivstg-vihgdd-eng.php

  4. (2014) Quick reference guide—laboratory testing for the diagnosis of HIV infection: updated recommendations. Available at: https://stacks.cdc.gov/view/cdc/23446

  5. Jensen TO, Robertson P, Whybin R, Chambers I, Lahra M, Rawlinson W et al (2015) A signal-to-cutoff ratio in the Abbott architect HIV Ag/Ab Combo assay that predicts subsequent confirmation of HIV-1 infection in a low-prevalence setting. J Clin Microbiol 53(5):1709–1711

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ramos EM, Harb S, Dragavon J, Swenson P, Stekler JD, Coombs RW (2013) Performance of an alternative HIV diagnostic algorithm using the ARCHITECT HIV Ag/Ab Combo assay and potential utility of sample-to-cutoff ratio to discriminate primary from established infection. J Clin Virol 58(Suppl 1):e38–e43

    Article  PubMed  PubMed Central  Google Scholar 

  7. Acar A, Kemahli S, Altunay H, Kosan E, Oncul O, Gorenek L et al (2010) The significance of repeat testing in Turkish blood donors screened with HBV, HCV and HIV immunoassays and the importance of S/CO ratios in the interpretation of HCV/HIV screening test results and as a determinant for further confirmatory testing. Transfus Med 20(3):152–159

    Article  PubMed  Google Scholar 

  8. Chavez P, Wesolowski L, Patel P, Delaney K, Owen SM (2011) Evaluation of the performance of the Abbott ARCHITECT HIV Ag/Ab Combo Assay. J Clin Virol 52(Suppl 1):S51–S55

    Article  PubMed  CAS  Google Scholar 

  9. Kim S, Lee JH, Choi JY, Kim JM, Kim HS (2010) False-positive rate of a “fourth-generation” HIV antigen/antibody combination assay in an area of low HIV prevalence. Clin Vaccine Immunol 17(10):1642–1644

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  10. Chacon L, Mateos ML, Holguin A (2017) Relevance of cutoff on a 4th generation ELISA performance in the false positive rate during HIV diagnostic in a low HIV prevalence setting. J Clin Virol 92:11–13

    Article  PubMed  Google Scholar 

  11. Bhattacharya R, Barton S, Catalan J (2008) When good news is bad news: psychological impact of false positive diagnosis of HIV. AIDS Care 20(5):560–564

    Article  PubMed  Google Scholar 

  12. McInnes CW, Druyts E, Harvard SS, Gilbert M, Tyndall MW, Lima VD et al (2009) HIV/AIDS in Vancouver, British Columbia: a growing epidemic. Harm Reduct J 6:5

    Article  PubMed  PubMed Central  Google Scholar 

  13. (2016) HIV in Canada: surveillance summary tables, 2014–2015. Available at: http://www.healthycanadians.gc.ca/publications/diseases-conditions-maladies-affections/hiv-aids-surveillance-2015-vih-sida/index-eng.php

  14. (2015) HIV in British Columbia: annual surveillance report 2014. Available at: http://www.bccdc.ca/util/about/annreport/default.htm

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Payne.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, L., Puddicombe, D., Champagne, S. et al. HIV serology signal-to-cutoff ratio as a rapid method to predict confirmation of HIV infection. Eur J Clin Microbiol Infect Dis 37, 1589–1593 (2018). https://doi.org/10.1007/s10096-018-3290-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-018-3290-y

Keywords

Navigation