• According to the National Aids and STIs Control Programme (Nascop), while all HIV tests kits globally are extremely accurate, none achieves a 100 per cent accuracy.
• That means there is always a small number of people who receive positive results from a test, when they in fact do not have HIV.
Image: FILE
Just as Kenyans resumed normal life in 2021 following Covid-19 lockdowns, one man was smarting from a more traumatic experience.
The 22-year-old from Kisumu took HIV tests, some returning indeterminate and others positive results.
He received the HIV diagnosis and was placed on ARVs, which he took for five months.
Luckily for him, he was participating in a vaccine study that required periodic review.
His biannual review suggested low-risk factors for infection. He also lacked the clinical signs for HIV infection. Supplementary confirmatory tests were performed and he was determined to be HIV negative, after five months. The antiretroviral therapy was discontinued.
His account was reported in the ID Cases journal, through an article titled “False reactive HIV-1 diagnostic test results in an individual from Kenya on multiple testing platforms.”
According to the National Aids and STIs Control Programme (Nascop), while all HIV tests kits globally are extremely accurate, none achieves a 100 per cent accuracy.
That means there is always a small number of people who receive positive results from a test, when they in fact do not have HIV. That is why Kenya requires two tests, the second being a confirmatory test.
Nascop director Dr Rose Wafula said they are now moving ahead to implement three-test strategy recommended by the World Health Organization.
The rollout begins the first week of July.
The WHO recommends a three-test strategy when a country’s prevalence drops below five per cent. Kenya’s national HIV prevalence is about 4.9 per cent.
“We are therefore changing the current two-test strategy and algorithm and adopt the three-test strategy in line with WHO recommendations,” Dr Wafula said.
In the three-test strategy, you can only be told you have HIV after three consecutive reactive (positive) tests.
According to modelling by WHO, the chances of having a false positive depends on how common HIV is in the community.
Although false positive results are extremely rare, they are more likely in settings where fewer people have HIV, which is why as the prevalence drops, more confirmation tests are needed.
Dr Wafula said they have grouped the 47 counties into five clusters.
“We don’t want to waste the test kits that are already there so we will have a phased approach. We tell them to complete use of the old kits for the old algorithm before we embark on the new approach. Region one is the arid and semi-arid land (Asal) counties,” she said.
“By July we will fully move into the new algorithm.”
Dr Wafula said people already taking ARVs do not need to retest.
“No they shouldn’t. A truly positive person on treatment needs not change anything,” she said.
This means once the roll out is complete, Kenyans who test for HIV will have their blood tested on three different kits that work in slightly different ways.
If you will be told that you are HIV positive or negative after the three tests, you can be confident that is the case.
Last week, Health PS Harry Kimtai said Kenya ranks among the first 10 countries to follow WHO's directive to adopt the three-test algorithm.
"Following a stringent process for adopting WHO protocol to the country by a stakeholder task force, Kenya is among the first 10 countries transitioning to the three test algorithm for HIV diagnosis," the PS said in a statement.
He said WHO highlights protocols where three different test kits are used in a sequential manner for HIV diagnosis.
"The three-test algorithm marks a pivotal advancement in diagnostic accuracy, which is critical in Kenya's fight against HIV-Aids, underscoring the ministry's dedication to the health and well-being of citizens," he said.
Kenya has the seventh largest HIV epidemic in the world, with an estimated 1.4 million people living with HIV.
By end of 2023, about 1,336,234 people were receiving HIV treatment at 3,752 facilities across the country.
Annually, over eight million HIV tests are conducted across different populations in 8,851 HIV testing facilities across the country.
Kimtai said this progress results from consistent policy guidance by the ministry to support and ensure accurate and safe HIV testing, comprehensive care and prevention services for all Kenyans.