Nigerians will soon be able to ascertain their HIV status from the comfort of their homes, the Minister of Health, Isaac Adewole, has said. Mr Adewole, on Friday in Abuja, approved a new HIV self-testing kit called Alere HIV Combo (AHC) Rapid Test Kit, which can be used by an individual in the comfort of their homes.
The kit will provide accurate results in 20 minutes and can be run using blood gotten by pricking a finger or serum/plasma. Mr Adewole said the kit is a new addition to the already existing laboratory and hospital modes of confirming HIV status within the country. The minister also launched the evaluation report and operational guideline for HIV self-testing in Nigeria. He said the launch of the Nigeria HIV/AIDs Indicator and Impact Survey (NAIIS) report showed that Nigeria still has a lot of work to do to suppress HIV in the country.
’90-90-90 target’
According to the report, Nigeria had made significant progress and is on course to meet the ‘UNAIDS global 90-90-90 target’. The 90:90:90 targets 90 per cent of people who are infected to know their HIV status; it targets 90 per cent of those who know their status to start receiving antiretroviral therapy (ART) and targets 90 per cent of those on ART to have their viral load suppressed.
However, the minister said HIV testing is very important in achieving the agenda. He said the emergence of the self-test kit represents a step forward. He said it ”is something everyone should be able to walk into a drug store to purchase.” Testing for HIV is the first ‘knight’; in other words, we cannot successfully implement HIV testing, prevention and management programme if we do not know our HIV status. We aim at improving the algorithm and making sure that we have convenient testing methodologies and this remains an essential component of our strategy,” he said.
Myth
Mr Adewole said the myth about HIV remains one of the factors affecting people’s willingness to go to hospitals and laboratories to get tested. ”There is so much fear and the need for confidentiality. As such, any test that can be done by an individual should be welcome. It reduces stigma; it reduces the embarrassment that usually goes with HIV testing.” Mr Adewole also expressed fears that people who test positive using the test kit might present themselves at the health facilities for treatment.
“That for me is the greatest challenge. Because if you test positive and you do not move forward, then you have not helped the situation. That has created some challenges for many of us as to whether we should adopt self-testing or we should handle self-testing as one of those things that can be done but not deployed as republic health situation,” he said.
Mr Adewole said so far, about 1.1 million people are undergoing treatment and ”about 800, 000 more people are still meant to be put on treatment”. “What is also important is that we need to get to a situation where all Nigerians know their status. I think that should be the cardinal point and every Nigerian should desire to be in that point.”
Test kit
Speaking on the evaluation of the self-test kit, the chairman of the test team, Ali Onoja, said rapid test kit evaluation is considered a critical aspect in the quality of test results. He said at present, the available rapid test kits can only detect HIV infection after the window period.The HIV window period is the time between potential exposure to HIV infection and the point when the test will give an accurate result.
This is usually a time frame of four weeks from the time of exposure. During the window period, a person can be infected with HIV and be very infectious, but still test HIV negative. Mr Onoja, however, said the manufacturers of Alere HIV Combo, however, claim the test kit ”detects both antibodies and the P24 (window period) antigen in the whole plasma or serum.” “In addition to laboratory performance, characteristics like sensitivity, specificity and accuracy of the test kit were evaluated to determine if the AHC can detect early infections that are antibody-negative by discovering the P24 antigens.
“The sensitivity, specificity and accuracy of AHC were 99.7 per cent, 98.7 per cent and 99.5 per cent respectively.”
Limitation
The kit cannot, however, ‘pick’ the virus during the window period, the team said. The team was unable to establish that the test kit could”pick the infection in the blood” during the window period. Picking the presence of the HIV antigen in the body during the window period can be of importance because it helps to place the infected person on early treatment. Mr Onoja said the inability of the AHC to detect the P24 in the negative specimen might be because either the specimens were truly negative for HIV infection or that the test device ”cannot detect P24 in the Nigerian setting”. Premium Times
Pix: A HIV test kit
