Abstrak 
Screening and Diagnosis of HIV-infection in Indonesia : One, Two or Threee Test ?
Agnes R Indrati, Reinout van Crevel, Ida Parwati, Anna Tjandrawati, Noormartany, July Kumalawati
Unpad
Inggris
Unpad
HIV-diagnosis, initial HIV-test
Aim :to examine among higt-risk populationa or patients with signs or symptoms suggesting HIV-infection,two test or even one single test might be sufficiently accurate for diagnosis of HIV in a hospital setting in Indonesia. Methods: we retrospectively examined the rate of falsepositive results of initial HIV-test for all subjects tested in the referral hospital for HIV in West-Java, Indonesia, between 2006 and 2008. We also calculated the positive and negative predictive value og single tset result and dual-testing, based on sensitivity and specifity of commonly used methods and prevelence data from Indonesia. Results : Among 3121 subjects, 803 were tested positive (25.7%). The initial rapid HIV-tests did not show a single false positive result, and no discrepancy was found between the second and third supplemental test. Based on their high accury, most rapid test carry a low risk of false-positive results among risk groups. Dual testing algorithms almost eliminate the risk of false-positive HIV-result, and are probably as accurate as three test, even in low prevalence settings.Conclusion: based on expected prevalance rates and the accuracy of methods used in Indonesia, one or two tests are usually accurate for HIV-diagnosis, especially for high risk populations. The possible implications and optimal conditions for more simple testing algorithms warrant further investigation.