Presumptive diagnosis of severe HIV infection to determine the need for antiretroviral therapy in children less than 18 months of age
Nicolas Grundmann, Peter Iliff, Jeff Stringer & Catherine Wilfert
Volume 89, Number 7, July 2011, 513-520
Table 4. Test characteristics and sensitivity analyses of three algorithms for identifying infants with the human immunodeficiency virus (HIV) at high risk of dying and in need of antiretrovirals, by infant age at testing
| Characteristic | MCC only |
MCC + RAT |
MCC + RAT + CD4 count |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Analysis |
Analysis |
Analysis |
|||||||||
| 1 | 2 | 3 | 1 | 2 | 3 | 1 | 2 | 3 | |||
| 6 weeks | |||||||||||
| qa | 0.50 | 0.75 | 1.00 | 0.50 | 0.75 | 1.00 | 0.50 | 0.75 | 1.00 | ||
| SE (%) | 43.4 | 33.3 | 27.4 | 43.4 | 33.3 | 27.4 | 83.2 | 91.3 | 99.9 | ||
| SP (%) | 94.4 | 94.3 | 94.2 | 94.5 | 94.4 | 94.3 | 94.0 | 94.0 | 94.1 | ||
| PPV (%) | 30.3 | 30.3 | 30.3 | 30.7 | 30.7 | 30.7 | 60.9 | 60.9 | 60.9 | ||
| NPV (%) | 96.7 | 95.0 | 93.4 | 96.8 | 95.0 | 93.4 | 98.0 | 99.1 | 99.9 | ||
| 6 months | |||||||||||
| qa | 0.50 | 0.75 | 1.00 | 0.50 | 0.75 | 1.00 | 0.50 | 0.75 | 1.00 | ||
| SE (%) | 80.5 | 73.7 | 68.0 | 81.4 | 73.7 | 68.0 | 83.1 | 91.2 | 99.9 | ||
| SP (%) | 85.4 | 85.3 | 85.2 | 92.7 | 92.6 | 92.5 | 92.3 | 92.4 | 92.5 | ||
| PPV (%) | 34.5 | 34.5 | 34.5 | 51.1 | 51.1 | 51.1 | 60.6 | 60.6 | 60.6 | ||
| NPV (%) | 97.9 | 96.9 | 95.9 | 98.1 | 97.1 | 96.2 | 97.5 | 98.8 | 99.9 | ||
| 12 months | |||||||||||
| qa | 0.50 | 0.75 | 1.00 | 0.50 | 0.75 | 1.00 | 0.50 | 0.75 | 1.00 | ||
| SE (%) | 91.9 | 88.0 | 85.0 | 91.9 | 88.6 | 84.9 | 88.5 | 94.2 | 99.9 | ||
| SP (%) | 91.0 | 90.9 | 90.9 | 99.5 | 99.5 | 99.5 | 99.5 | 99.5 | 99.5 | ||
| PPV (%) | 61.6 | 61.6 | 61.6 | 96.9 | 96.9 | 96.9 | 97.3 | 97.3 | 97.3 | ||
| NPV (%) | 98.6 | 97.9 | 97.2 | 98.7 | 98.2 | 97.5 | 97.8 | 98.9 | 99.9 | ||
CD4, CD4+ T lymphocyte; MCC, modified clinical criteria; NPV, negative predictive value; PPV, positive predictive value; RAT, rapid antibody test; SE, sensitivity; SP, specificity.
a Coefficient of correlation between the results of clinical screening and of World Health Organization clinical staging.