In terms of outcome measures statistically significant diffe

In terms of outcome measures, statistically significant differences were only observed in need for invasive mechanical ventilation (23% vs 46%, p-value 0.005) and in-hospital mortality (13% vs 37%, p-value 0.002). Both these outcomes were still statistically significant following adjustment for confounders (p-values of 0.015 and 0.037 respectively), resulting in a 0.6 and 0.5 times risk for invasive mechanical ventilation and mortality for HIV patients. There was no statistically significant difference in the need for corticotherapy or non-invasive mechanical ventilation (Table 4).
Conclusion
Conflicts of interest
Acknowledgments
Background An accurate laboratory diagnosis of HIV is a cornerstone of national HIV programs and essential for patient management and subsequent treatment. In June 2014 the US Centers for Disease Control and Prevention presented an updated diagnostic algorithm. It consists of a combined screening assay simultaneously detecting HIV-1/2 antibodies and p24 antigen, followed by confirmation and HIV-type differentiation by a serological test. If the HIV-type differentiation assay is nonreactive or indeterminate HIV-1 nucleic colorimetric assay australia amplification test (NAAT) is recommended (Centers for Disease Control and Prevention and Association of Public Health Laboratories, 2014). Verification of a serologically suspected HIV-2 infection is not straightforward as many HIV-2 infected patients have undetectable or significantly lower HIV-2 RNA plasma viral load compared to HIV-1 plasma viral load (Andersson et al., 2000). Thus a negative result does not exclude HIV-2 infection. Furthermore HIV-2 genomic testing is often not available in low resource settings and HIV-type discrimination relies on serological tests (Jespersen et al., 2014). HIV-2 is inherently resistant to non-nucleoside reverse transcriptase inhibitors, commonly used as a first-line antiretroviral treatment (ART) of HIV-1 in sub-Saharan Africa (Visseaux et al., 2016). Therefore it is important to be able to discriminate between HIV-1, HIV-2 and HIV-1/2 dual infection to avoid HIV-2 and HIV-1/2 dually infected patients to be wrongly classified as HIV-1 positive and put on inappropriate ART. HIV-2 is most prevalent in West Africa but minor HIV-2 epidemics have been established in countries in southern Europe with historical relations to West Africa and through immigration to India and the United States of America (Visseaux et al., 2016). Globally, Guinea-Bissau has the highest prevalence of HIV-2 but over the last 30 years prevalence rates of HIV-2 have been declining while the HIV-1 prevalence has been increasing (Mansson et al., 2007; Olesen et al., 2018). Consequently both HIV viruses co-exist with a number of intra-patient coinfections. ImmunoComb HIV 1/2 BiSpot (Orgenics, Yavne, Israel) (Mansson et al., 2007, 2009; Tchounga et al., 2016, 2014) and INNO-LIA HIV 1/2 Score (Fujirebio, Ghent, Belgium) (Chaillet et al., 2010; Zbinden et al., 2016) are two serological tests that have been widely used for HIV confirmation and HIV-type discrimination. As the production of Immunocomb now has ceased Nonsense codon has prompted us to evaluate a new strategy for HIV confirmation and HIV-type discrimination in a setting with high numbers of HIV-2 and HIV-1/2 infected individuals. Geenius HIV 1/2 Confirmatory Assay (Bio-Rad, Marnes-al-Coquette, France) is a new confirmatory test for HIV discrimination which has previously been evaluated with regard to discriminatory capacity between HIV-1 and HIV-2 (Abbate et al., 2014; Fordan et al., 2017; Friedrichs et al., 2015; Herssens et al., 2014; Malloch et al., 2013; Montesinos et al., 2014; Tinguely et al., 2014). However, these evaluations have included no or only a few samples of HIV-1/2 dually reactive patients. The objective of the present study was to evaluate Geenius against INNO-LIA and Immunocomb with an emphasis towards ability to discriminate between HIV-1, HIV-2 and HIV-1/2 dual infection.