Unequal Detection of HIV Type 1 Group O Infection by Simple Rapid Tests

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To the Editor—Given our particular involvement in human immunodeficiency virus (HIV) screening with simple rapid tests (SRTs) in developing countries, we read with great interest the articles by Novitsky et al. [1] and Corcoran et al. [2] in Clinical Infectious Diseases. Each of them reported a case of antibody-negative HIV type 1 (HIV-1) subtype C infection (in Botswana and South Africa, respectively). Cameroon is another African country where HIV-1 is characterized by extensive genetic variability, with the existence of the most-divergent HIV-1 strains, HIV-1 group O and group N [3, 4]. Recently, Determine HIV-1/2 (Inverness Medical Innovations) and Immunocomb II HIV-1/2 bispot (Orgenics) tests used in Cameroon for the 2-SRT HIV screening strategy were replaced by Retrocheck HIV-WB (Qualpro Diagnostics) and SD Bioline HIV-1/2 3.0 (Standard Diagnostics). These new tests had been evaluated by 2 studies, in the Central African Republic and South India, and demonstrated high sensitivity and specificity (100% and 98.0%, respectively, for Retrocheck HIV-WB and 100% and 99.4%, respectively, for SD Bioline HIV-1/2 3.0) [5, 6]. Nevertheless, we noted that no serum sample had been serotyped as indicating HIV-1 group O infection in these studies.

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