The use of the GeeniusTM HIV‐1/2 Rapid confirmatory test for the enrolment of patients and blood donors in the WHO Universal Test and Treat Strategy in Cameroon, Africa

Background and objective In the WHO Universal test and treat strategy, false‐positive HIV blood donors and patients may be unnecessarily put under antiretroviral treatment and false‐negative subjects may be lost to follow‐up. This study assessed the false positivity rate of the Cameroonian national HIV screening testing algorithm and the benefit of a confirmation test in the enrolment of patients and donors in the HIV care programme. Methods We included initial HIV reactive blood donors and patients in a cross‐sectional study conducted in two Cameroonian hospitals. Samples were retested according to the Cameroon national algorithm for HIV diagnosis. A positive or discordant sample was retested with the Geenius Bio‐Rad HIV 1&2 (Bio‐Rad, Marnes‐la‐Coquette, France) for confirmation. The Geenius HIV‐1‐positive results with ‘poor’ profiles were retested for RNA as well as the Geenius indeterminate results. Results Of the 356 participants, 190/225 (84·4%) patients and 76/131 (58%) blood donors were declared positive with the national algorithm; 257 participants (96·6%) were confirmed HIV‐1‐positive. The study revealed that about 34/1000 blood donors and patients are false‐positive and unnecessarily put on treatment; 89/1000 blood donors and patients declared discordant could have been included immediately in the HIV care programme if confirmatory testing was performed. The second test of the algorithm had a false‐negative rate of 3%. Eleven samples (3·1%) were Geenius poor positive and NAT negative. Conclusion The universal test and treat strategy may identify and refer more individuals to HIV care if a third rapid confirmatory test is performed for discordant cases.