The Experts below are selected from a list of 8562 Experts worldwide ranked by ideXlab platform
E Aldabó - One of the best experts on this subject based on the ideXlab platform.
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BCN Checkpoint: same-day confirmation of reactive HIV Rapid Test with Point Of Care HIV-RNA accelerates linkage to care and reduces anxiety.
HIV Medicine, 2018Co-Authors: Michael Meulbroek, Ferran Pujol, F Pérez, A Dalmau-bueno, H Taboada, G Marazzi, A Carrillo, A Cabas, A Gata, E AldabóAbstract:Background The introduction in 2006 of the Rapid HIV Test by BCN Checkpoint in a non-clinical setting has been a successful step forwards in the uptake of Testing. Nevertheless, HIV serostatus should be reported as HIV positive only when a reactive result has been Tested again using a different assay (WHO guidelines 2015). The standard confirmation Test has been the Western Blot (WB) Test. However confirmation results take around 7 days to come back. Aims This study explores the possibility of Point of Care PCR Testing for a same-day confirmation. Materials and methods Between March 2015 and September 2016 a POC PCR Test (Xpert® HIV-1 Qual) was performed in parallel to the Western Blot Test after a reactive HIV Rapid Test (Alere Determine™ HIV-1/2 Ag/Ab Combo and Alere™ HIV Combo). HIV confirmed positive cases received emotional support by peers, were informed and prepared for treatment initiation and Rapidly linked to HIV clinic. Results During the study period 11 455 Tests were performed to 7163 clients. A total of 249 reactive Rapid HIV Tests were found. For analysis a total of 33 cases were excluded due to the lack of PCR and/or WB Test. Results of comparison of the 216 cases showed 194 concordant positive confirmations and 14 concordant negative results. In three cases PCR was positive and WB negative. In five cases PCR was negative and WB positive. Conclusion The POC PCR assay is easy to use and feasible in a community-based center. Reducing time for confirmation to 90 min has been possible in 91.2% (197/216) of cases with positive PCR result. In cases of a negative PCR result an additional Test (WB, Elisa or PCR quantitative) was needed to distinguish false positive results (6.5%) from viral load results below level of detection (2.3%). Clients expressed satisfaction with same-day confirmation and less anxiety.
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BCN Checkpoint: same-day confirmation of reactive HIV Rapid Test with Point Of Care HIV-RNA accelerates linkage to care and reduces anxiety.
HIV medicine, 2018Co-Authors: Michael Meulbroek, Ferran Pujol, F Pérez, A Dalmau-bueno, H Taboada, G Marazzi, A Carrillo, A Cabas, A Gata, E AldabóAbstract:The introduction in 2006 of the Rapid HIV Test by BCN Checkpoint in a non-clinical setting has been a successful step forwards in the uptake of Testing. Nevertheless, HIV serostatus should be reported as HIV positive only when a reactive result has been Tested again using a different assay (WHO guidelines 2015). The standard confirmation Test has been the Western Blot (WB) Test. However confirmation results take around 7 days to come back. This study explores the possibility of Point of Care PCR Testing for a same-day confirmation. Between March 2015 and September 2016 a POC PCR Test (Xpert® HIV-1 Qual) was performed in parallel to the Western Blot Test after a reactive HIV Rapid Test (Alere Determine™ HIV-1/2 Ag/Ab Combo and Alere™ HIV Combo). HIV confirmed positive cases received emotional support by peers, were informed and prepared for treatment initiation and Rapidly linked to HIV clinic. During the study period 11 455 Tests were performed to 7163 clients. A total of 249 reactive Rapid HIV Tests were found. For analysis a total of 33 cases were excluded due to the lack of PCR and/or WB Test. Results of comparison of the 216 cases showed 194 concordant positive confirmations and 14 concordant negative results. In three cases PCR was positive and WB negative. In five cases PCR was negative and WB positive. The POC PCR assay is easy to use and feasible in a community-based center. Reducing time for confirmation to 90 min has been possible in 91.2% (197/216) of cases with positive PCR result. In cases of a negative PCR result an additional Test (WB, Elisa or PCR quantitative) was needed to distinguish false positive results (6.5%) from viral load results below level of detection (2.3%). Clients expressed satisfaction with same-day confirmation and less anxiety. © 2018 British HIV Association.
Maria L Alcaide - One of the best experts on this subject based on the ideXlab platform.
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implementation of an immediate HIV treatment initiation program in a public academic medical center in the u s south the miami Test and treat Rapid response program
Aids and Behavior, 2019Co-Authors: Allan E Rodriguez, Andrew J Wawrzyniak, Hansel E Tookes, Marcia G Vidal, Manasi Soni, Rita Nwanyanwu, David Goldberg, Rachel Freeman, Kira Villamizar, Maria L AlcaideAbstract:Test and Rapid Response Treatment (TRRT) linkage programs have demonstrated improved HIV suppression rates. This paper describes the design and implementation of the Miami TRRT initiative and its clinical impact. Assisted by a dedicated care navigator, patients receiving a reactive HIV Rapid Test at the Florida Department of Health STD Clinic were offered same-day HIV care at the University of Miami/Jackson Memorial Medical Center Adult HIV Outpatient Clinic. Patient retention and labs were tracked for 12 months. Of the 2337 individuals Tested, 46 had a reactive HIV Test; 41 (89%) consented to participate. For the 36 patients in continued care for a year, 33 (91.7%) achieved virological suppression (< 200 copies/mL) within 70 days of their reactive HIV Rapid Test; at 12 months, 35 (97.2%) remained suppressed, and mean CD4 T cell counts increased from 452 ± 266 to 597 ± 322 cells/mm3. The Miami TRRT initiative demonstrated that immediate linkage to care is feasible and improves retention and suppression in a public/academic medical center in the U.S. South.
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Implementation of an Immediate HIV Treatment Initiation Program in a Public/Academic Medical Center in the U.S. South: The Miami Test and Treat Rapid Response Program.
AIDS and behavior, 2019Co-Authors: Allan E Rodriguez, Andrew J Wawrzyniak, Hansel E Tookes, Marcia G Vidal, Manasi Soni, Rita Nwanyanwu, David Goldberg, Rachel Freeman, Kira Villamizar, Maria L AlcaideAbstract:Test and Rapid Response Treatment (TRRT) linkage programs have demonstrated improved HIV suppression rates. This paper describes the design and implementation of the Miami TRRT initiative and its clinical impact. Assisted by a dedicated care navigator, patients receiving a reactive HIV Rapid Test at the Florida Department of Health STD Clinic were offered same-day HIV care at the University of Miami/Jackson Memorial Medical Center Adult HIV Outpatient Clinic. Patient retention and labs were tracked for 12 months. Of the 2337 individuals Tested, 46 had a reactive HIV Test; 41 (89%) consented to participate. For the 36 patients in continued care for a year, 33 (91.7%) achieved virological suppression (
Michael Meulbroek - One of the best experts on this subject based on the ideXlab platform.
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BCN Checkpoint: same-day confirmation of reactive HIV Rapid Test with Point Of Care HIV-RNA accelerates linkage to care and reduces anxiety.
HIV Medicine, 2018Co-Authors: Michael Meulbroek, Ferran Pujol, F Pérez, A Dalmau-bueno, H Taboada, G Marazzi, A Carrillo, A Cabas, A Gata, E AldabóAbstract:Background The introduction in 2006 of the Rapid HIV Test by BCN Checkpoint in a non-clinical setting has been a successful step forwards in the uptake of Testing. Nevertheless, HIV serostatus should be reported as HIV positive only when a reactive result has been Tested again using a different assay (WHO guidelines 2015). The standard confirmation Test has been the Western Blot (WB) Test. However confirmation results take around 7 days to come back. Aims This study explores the possibility of Point of Care PCR Testing for a same-day confirmation. Materials and methods Between March 2015 and September 2016 a POC PCR Test (Xpert® HIV-1 Qual) was performed in parallel to the Western Blot Test after a reactive HIV Rapid Test (Alere Determine™ HIV-1/2 Ag/Ab Combo and Alere™ HIV Combo). HIV confirmed positive cases received emotional support by peers, were informed and prepared for treatment initiation and Rapidly linked to HIV clinic. Results During the study period 11 455 Tests were performed to 7163 clients. A total of 249 reactive Rapid HIV Tests were found. For analysis a total of 33 cases were excluded due to the lack of PCR and/or WB Test. Results of comparison of the 216 cases showed 194 concordant positive confirmations and 14 concordant negative results. In three cases PCR was positive and WB negative. In five cases PCR was negative and WB positive. Conclusion The POC PCR assay is easy to use and feasible in a community-based center. Reducing time for confirmation to 90 min has been possible in 91.2% (197/216) of cases with positive PCR result. In cases of a negative PCR result an additional Test (WB, Elisa or PCR quantitative) was needed to distinguish false positive results (6.5%) from viral load results below level of detection (2.3%). Clients expressed satisfaction with same-day confirmation and less anxiety.
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BCN Checkpoint: same-day confirmation of reactive HIV Rapid Test with Point Of Care HIV-RNA accelerates linkage to care and reduces anxiety.
HIV medicine, 2018Co-Authors: Michael Meulbroek, Ferran Pujol, F Pérez, A Dalmau-bueno, H Taboada, G Marazzi, A Carrillo, A Cabas, A Gata, E AldabóAbstract:The introduction in 2006 of the Rapid HIV Test by BCN Checkpoint in a non-clinical setting has been a successful step forwards in the uptake of Testing. Nevertheless, HIV serostatus should be reported as HIV positive only when a reactive result has been Tested again using a different assay (WHO guidelines 2015). The standard confirmation Test has been the Western Blot (WB) Test. However confirmation results take around 7 days to come back. This study explores the possibility of Point of Care PCR Testing for a same-day confirmation. Between March 2015 and September 2016 a POC PCR Test (Xpert® HIV-1 Qual) was performed in parallel to the Western Blot Test after a reactive HIV Rapid Test (Alere Determine™ HIV-1/2 Ag/Ab Combo and Alere™ HIV Combo). HIV confirmed positive cases received emotional support by peers, were informed and prepared for treatment initiation and Rapidly linked to HIV clinic. During the study period 11 455 Tests were performed to 7163 clients. A total of 249 reactive Rapid HIV Tests were found. For analysis a total of 33 cases were excluded due to the lack of PCR and/or WB Test. Results of comparison of the 216 cases showed 194 concordant positive confirmations and 14 concordant negative results. In three cases PCR was positive and WB negative. In five cases PCR was negative and WB positive. The POC PCR assay is easy to use and feasible in a community-based center. Reducing time for confirmation to 90 min has been possible in 91.2% (197/216) of cases with positive PCR result. In cases of a negative PCR result an additional Test (WB, Elisa or PCR quantitative) was needed to distinguish false positive results (6.5%) from viral load results below level of detection (2.3%). Clients expressed satisfaction with same-day confirmation and less anxiety. © 2018 British HIV Association.
Allan E Rodriguez - One of the best experts on this subject based on the ideXlab platform.
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implementation of an immediate HIV treatment initiation program in a public academic medical center in the u s south the miami Test and treat Rapid response program
Aids and Behavior, 2019Co-Authors: Allan E Rodriguez, Andrew J Wawrzyniak, Hansel E Tookes, Marcia G Vidal, Manasi Soni, Rita Nwanyanwu, David Goldberg, Rachel Freeman, Kira Villamizar, Maria L AlcaideAbstract:Test and Rapid Response Treatment (TRRT) linkage programs have demonstrated improved HIV suppression rates. This paper describes the design and implementation of the Miami TRRT initiative and its clinical impact. Assisted by a dedicated care navigator, patients receiving a reactive HIV Rapid Test at the Florida Department of Health STD Clinic were offered same-day HIV care at the University of Miami/Jackson Memorial Medical Center Adult HIV Outpatient Clinic. Patient retention and labs were tracked for 12 months. Of the 2337 individuals Tested, 46 had a reactive HIV Test; 41 (89%) consented to participate. For the 36 patients in continued care for a year, 33 (91.7%) achieved virological suppression (< 200 copies/mL) within 70 days of their reactive HIV Rapid Test; at 12 months, 35 (97.2%) remained suppressed, and mean CD4 T cell counts increased from 452 ± 266 to 597 ± 322 cells/mm3. The Miami TRRT initiative demonstrated that immediate linkage to care is feasible and improves retention and suppression in a public/academic medical center in the U.S. South.
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Implementation of an Immediate HIV Treatment Initiation Program in a Public/Academic Medical Center in the U.S. South: The Miami Test and Treat Rapid Response Program.
AIDS and behavior, 2019Co-Authors: Allan E Rodriguez, Andrew J Wawrzyniak, Hansel E Tookes, Marcia G Vidal, Manasi Soni, Rita Nwanyanwu, David Goldberg, Rachel Freeman, Kira Villamizar, Maria L AlcaideAbstract:Test and Rapid Response Treatment (TRRT) linkage programs have demonstrated improved HIV suppression rates. This paper describes the design and implementation of the Miami TRRT initiative and its clinical impact. Assisted by a dedicated care navigator, patients receiving a reactive HIV Rapid Test at the Florida Department of Health STD Clinic were offered same-day HIV care at the University of Miami/Jackson Memorial Medical Center Adult HIV Outpatient Clinic. Patient retention and labs were tracked for 12 months. Of the 2337 individuals Tested, 46 had a reactive HIV Test; 41 (89%) consented to participate. For the 36 patients in continued care for a year, 33 (91.7%) achieved virological suppression (
Estelle Piwowar-manning - One of the best experts on this subject based on the ideXlab platform.
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Understanding low sensitivity of community‐based HIV Rapid Testing: experiences from the HPTN 071 (PopART) trial in Zambia and South Africa
Journal of the International AIDS Society, 2017Co-Authors: Peter Bock, Estelle Piwowar-manning, Comfort R. Phiri, Barry Kosloff, Nomtha Mandla, Alicia Young, Anelet James, A. B. Schaap, Michelle Scheepers, Deborah DonnellAbstract:Introduction : Population-wide HIV Testing services (HTSs) must be delivered in order to achieve universal antiretroviral treatment (ART) coverage. To accurately deliver HTS at such scale, non-facility-based HIV point-of-care Testing (HIV-POCT) is necessary but requires rigorous quality assurance (QA). This study assessed the performance of community-wide HTS in Zambia and South Africa (SA) as part of the HPTN 071 (PopART) study and explores the impact of quality improvement interventions on HTS performance. Methods : Between 2014 and 2016, HIV-POCT was undertaken within households both as part of the randomly selected HPTN 071 research cohort (Population Cohort [PC]) and as part of the intervention provided by community HIV-care providers. HIV-POCT followed national algorithms in both countries. Consenting PC participants provided a venous blood sample in addition to being offered HIV-POCT. We compared results obtained in the PC using a laboratory-based gold standard (GS) Testing algorithm and HIV-POCT. Comprehensive QA mechanisms were put in place to support the community-wide Testing. Participants who were identified as having a false negative or false positive HIV Rapid Test were revisited and offered reTesting. Results : We initially observed poor sensitivity (45–54%, 95% confidence interval [CI] 31–69) of HIV-POCT in the PC in SA compared to sensitivity in Zambia for the same time period of 95.8% (95% CI 93–98). In both countries, specificity of HIV-POCT was >98%. With enhanced QA interventions and adoption of the same HIV-POCT algorithm, sensitivity in SA improved to a similar level as in Zambia. Conclusions : This is one of the first reports of HIV-POCT performance during wide-scale delivery of HTS compared to a GS laboratory algorithm. HIV-POCT in a real-world setting had a lower sensitivity than anticipated. Appropriate choice of HIV-POCT algorithms, intensive training and supervision, and robust QA mechanisms are necessary to optimize HIV-POCT Test performance when Testing is delivered at a community level. HIV-POCT in clients who did not disclose that they were on ART may have contributed to false negative HIV-POCT results and should be the topic of future research. Keywords HIV Rapid Test; community; household; sensitivity; quality control; HPTN 071 (PopART) To access the supplementary material to this article please see Supplementary Files under Article Tools online. (Published: 29 August 2017) Bock P et al. Journal of the International AIDS Society 2017, 20 :21780 http://www.jiasociety.org/index.php/jias/article/view/21780 | http://dx.doi.org/10.7448/IAS.20.7.21780
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Failure to Identify HIV-Infected Individuals in a Clinical Trial Using a Single HIV Rapid Test for Screening
HIV clinical trials, 2014Co-Authors: Estelle Piwowar-manning, Jessica M. Fogel, Oliver Laeyendecker, Shauna Wolf, Vanessa Cummings, Mark A. Marzinke, William Clarke, Autumn Breaud, Sarah K. Wendel, Lei WangAbstract:AbstractBackground: In the HIV Prevention Trials Network (HPTN) 061 study, 8 (2.3%) of 348 HIV-infected participants identified as HIV uninfected at study enrollment using a single HIV Rapid Test for screening were found to be HIV infected after additional Testing. Objectives: To evaluate the performance of different HIV assays for detection of HIV infection in HPTN 061 participants with missed infection and individuals with viral suppression. Methods: Plasma samples from 8 HPTN 061 participants, 17 elite controllers, and 101 individuals on antiretroviral treatment (ART) were Tested for HIV with 3 Rapid Tests, 2 laboratory-based immunoassays, and a Western blot assay. The HPTN 061 samples were also Tested with 2 HIV RNA assays and an antiretroviral drug assay. Results: Of the 8 HPTN 061 participants with missed infection, 1 was an elite controller, 1 was taking ART, 2 were missed because of Testing or clerical errors, 1 had recent HIV infection (identified using a multi-assay algorithm), and 3 had acute H...
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HIV Surveillance in a Large, Community-Based Study: Results from the Pilot Study of Project Accept (HIV Prevention Trials Network 043)
BMC infectious diseases, 2011Co-Authors: Estelle Piwowar-manning, Oliver Laeyendecker, Deborah Donnell, Agnès Fiamma, Michal Kulich, Greg Szekeres, Laura Robins-morris, Caroline E. Mullis, Ana Vallari, John HackettAbstract:Background: Project Accept is a community randomized, controlled trial to evaluate the efficacy of community mobilization, mobile Testing, same-day results, and post-Test support for the prevention of HIV infection in Thailand, Tanzania, Zimbabwe, and South Africa. We evaluated the accuracy of in-country HIV Rapid Testing and determined HIV prevalence in the Project Accept pilot study. Methods: Two HIV Rapid Tests were performed in parallel in local laboratories. If the first two Rapid Tests were discordant (one reactive, one non-reactive), a third HIV Rapid Test or enzyme immunoassay was performed. Samples were designated HIV NEG if the first two Tests were non-reactive, HIV DISC if the first two Tests were discordant, and HIV POS if the first two Tests were reactive. Samples were re-analyzed in the United States using a panel of laboratory Tests. Results: HIV infection status was correctly determined based on-in country Testing for 2,236 (99.5%) of 2,247 participants [7 (0.37%) of 1,907 HIV NEG samples were HIV-positive; 2 (0.63%) of 317 HIV POS samples were HIV-negative; 2 (8.3%) of 24 HIV DISC samples were incorrectly identified as HIV-positive based on the in-country tie-breaker Test]. HIV prevalence was: Thailand: 0.6%, Tanzania: 5.0%, Zimbabwe 14.7%, Soweto South Africa: 19.4%, Vulindlela, South Africa: 24.4%, (overall prevalence: 14.4%). Conclusions: In-country Testing based on two HIV Rapid Tests correctly identified the HIV infection status for 99.5% of study participants; most participants with discordant HIV Rapid Tests were not infected. HIV prevalence varied considerably across the study sites (range: 0.6% to 24.4%). Trial Registration: ClinicalTrials.gov registry number NCT00203749.