Challenges of Discrepant HIV Tests in Pregnant Women in the PrEP era-to Treat or Not to Treat?

Wagner, Anjuli D; Kinuthia, John; Dettinger, Julia; Mwongeli, Nancy; Gómez, Laurén; Watoyi, Salphine; Drake, Alison L; Abuna, Felix et al. · J Infect Dis · 2021

prospective_cohort · Level II

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Abstract

During HIV retesting in antenatal and preexposure prophylaxis (PrEP) care, discrepant results occur, but guidelines are lacking. In a Kenyan trial implementing antenatal PrEP, if 1 test is reactive, a second is performed; if discrepant, both are repeated; if persistently discrepant, DNA polymerase chain reaction (PCR) is performed. Among 4451 women, 23 265 HIV retesting sessions were performed; 14 (0.06%, 95% confidence interval, 0.03%-0.10%) had discrepant results among 10 individuals; in all 10 initial cases, PCR was negative. Discrepant rapid tests are an expected, rare, and important challenge for antenatal care HIV retesting, with and without PrEP. NCT03070600.

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