Human Immunodeficiency Virus: Sensitivity and Specificity

Introduction: None written.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
1000	2%
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The sensitivity and specificity of findings for Human Immunodeficiency Virus are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Findings With Unspecified Accuracy
Finding	Result	Sensitivity	Specificity
[ + ] Thrush		No accuracy specified.
Study: no study specified.
[ + ] Salivary gland enlargement, bilateral		No accuracy specified.
Study: no study specified.

Sensitive and Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] p24 Antigen	+ 0 -	89%	100%
Study: Ann Intern Med 2001 Jan 2;134(1):25-9. PMID 11187417
[ + ] Blood Rapid Antibody Test	+ 0 -	99.7%	99.9%
from whole blood Study: AIDS. 2006 Aug 1;20(12):1655-1660. PMID 16868447
[ + ] Western Blot	+ 0 -	99.3%	99.7%
'window period' of seronegativity is approximately 3-6 weeks in newest-generation assays. p24 antigen should be sensitive in this timeframe. Study: CDC Survey, cited in UpToDate http://www.utdol.com/online/content/topic.do?topicKey=hiv_infe/5102
[ + ] HIV RNA PCR	+ 0 -	100%	97%
All false positives had levels < 2000 copies/ml. Study: Ann Intern Med 2001 Jan 2;134(1):25-9. PMID 11187417
[ + ] Oral Rapid Antibody Test	+ 0 -	99.9%	96.9%
aka "OraSure" or "OraQuick" . Another study found sens = 99.1% and spec = 99.6%. Study: sens: JAMA 1997 Jan 15;277(3):254-8. PMID 9005276 spec: Ann Intern Med. 2008 Aug 5;149(3):153-60. PMID 18678842 alternative: AIDS. 2006 Aug 1;20(12):1655-1660. PMID 16868447

Specific Findings
Finding	Result	Sensitivity	Specificity
[ + ] Genital Ulcer	+ 0 -	8%	99%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] genital wart	+ 0 -	2%	99%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Swollen Lymph Nodes	+ 0 -	11%	98%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Diarrhea	+ 0 -	8%	98%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Emesis	+ 0 -	13%	97%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] nausea	+ 0 -	10%	97%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Weight loss	+ 0 -	21%	96%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Arthralgia	+ 0 -	16%	96%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Oral ulcer	+ 0 -	13%	96%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Night Sweats	+ 0 -	12%	96%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Rash	+ 0 -	6%	96%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Fatigue	+ 0 -	22%	92%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Headache	+ 0 -	18%	91%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954
[ + ] Fever	+ 0 -	33%	90%
Study: Wood, E., Kerr, T., Rowell, G., Montaner, J. S. G., Phillips, P., Korthuis, P. T., & Simel, D. L. (2014). Does This Adult Patient Have Early HIV Infection? JAMA, 312(3), 278. doi:10.1001/jama.2014.5954