HIV test algorithm, low prevalence 2015 guideline

By pascal verhoeven | 02 Jun, 2018

Dear all,
In compliance with 2015 WHO guidelines a national HIV test algorithm follows a series of 3 distinct tests to maximize the positive predictive value of diagnosis (minimizing false positives). In updating our national test algorithm, because it is low prevalence, but at the same time a concentrated epidemic in KP, we also wanted to achieve maximum negative predictive value, not to rule out anyone who truly is infected by a false negative diagnosis.
This in my view can be promoted by using a 4th gen. RDT as T-1 (Determine combo) or by having a repeat test offered to KP who on T-1 are found non-reactive.
I thus would invite comments on the designed algorithm below adopted from WHO

thank you in advance