Prepared by: Bratislav Prokić, December 2022
Review: Prof. Dr. Biljana Kocić, epidemiologist,
Institute of Public Health - Niš
What are rapid HIV tests?
Rapid tests are adapted ELISA tests. They have a window period of 3 months. They detect antibodies that the body creates as a reaction to HIV infection after 1 to 3 months. A small blood sample from a finger is used for testing, and the result is read after 10-15 minutes. They are used for mass, anonymous testing in community organizations and in the field.
In addition to these rapid tests, there are: rapid tests of the fourth generation that have a window period of 6 weeks, those that show the result after two minutes, as well as rapid oral tests that detect HIV from the lungs. These types of rapid tests were not registered in Serbia at the time of writing.
What is the advantage of rapid tests?
Rapid tests are easy to use because no specialized laboratory equipment is required. The performance is almost painless using the automatic lancet. One of the most important advantages of the rapid test is that it shows the result in 10-15 minutes.
What are the disadvantages of rapid tests?
Rapid tests are generally third generation and reliably detect long-term infections (after two to three months), but are sometimes unable to detect recent HIV infections acquired in the past few weeks.
How reliable are rapid tests?
Tests registered in Serbia are extremely accurate and reliable - over 99.7%. The key measures of accuracy are sensitivity (percentage of results that are true positive when HIV is actually present) and specificity (percentage of results that are true negative when HIV is not present).
When is a rapid test unreliable?
Quick tests perform worse in several situations:
- With a possible recent infection, when antibodies have not yet developed.
- In people taking drugs for pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP), which can delay the production of antibodies in case of infection.
- In people with diagnosed HIV infection who are taking anti-HIV therapy (antiretroviral therapy). These tests are not a reliable way to confirm whether someone still has HIV infection.
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