Comparison was made with the Abbott Architect using whole blood, and the Bio-Rad oral fluid method as previously described. The results of the validation exercise are shown in Table 1, which shows the excellent performance characteristics of this method. In addition, automation was shown to speed up laboratory processes and reduce sample processing. The Oracol+ device can be directly loaded onto the Abbott platform, after centrifuging at 3000 rpm for 10 min (875.4 g), obviating the need

for manual aliquotting. The assay issues a result within 45 min. On the basis of the validation study and the benefits for the laboratory, fully automated oral fluid HIV testing was rolled out to a number of clinical sites

at Chelsea and Westminster. selleck Automated oral fluid HIV testing has been ongoing at a number of clinical sites, including the Emergency Department (as part of the HEDsUP NW London programme, reported elsewhere in this supplement) and the Colposcopy Department at Chelsea and Westminster Hospital. A total of 2960 tests have been performed. There have been eight reactive Talazoparib results. Of the four patients (50%) who have returned for confirmatory testing, three have been confirmed to be true positives. This yields a method-specific test specificity of 99.97% (95% CI 99.91–100.00%) with a positive predictive value in this population of 75% (prevalence of HIV in this population: 0.14%; 95% CI 0.00–0.27%). All newly diagnosed patients have transferred to care. Automation requires a minimum oral fluid volume of 200 μl. In the early phase, up to 12% of samples received were insufficient for automated testing, and had to be manually tested on the Bio-Rad system. With staff education in the field, minimum volumes have been easily achieved more recently. The method remains highly acceptable to both patients and staff. We

have developed acceptable, effective and sustainable oral fluid-based HIV testing methodologies. The performance characteristics of the manual and automated methods are both within acceptable limits. The low positive predictive value of the methods is probably a function of the low overall prevalence of HIV infection RAS p21 protein activator 1 in the populations tested. We are unable to cite a field sensitivity of the test, but sensitivity in the in-house validations of the manual and automated methods was recorded at 100%. A recent meta-analysis and systematic review of results obtained using the Orasure Ora-quick Advance® (OraSure Technologies, Inc.) in 45 studies across a number of settings provide evidence for good performance of the POCT on various biological specimens [9]. The authors found that the pooled sensitivity was about 2% lower for oral (98.03%; 95% CI 95.85–99.08%) than for blood-based specimens (99.