Biraro, SamuelMayaud, PhilippeMorrow, Rhoda AshleyGrosskurth, HeinerWeiss, Helen A.2022-06-092022-06-092011Biraro, S., Mayaud, P., Morrow, R. A., Grosskurth, H., & Weiss, H. A. (2011). Performance of commercial herpes simplex virus type-2 antibody tests using serum samples from Sub-Saharan Africa: a systematic review and meta-analysis. Sexually transmitted diseases, 140-147.https://nru.uncst.go.ug/handle/123456789/3858Several commercial type-specific serologic tests are available for herpes simplex virus type 2 (HSV-2). Poor specificity of some tests has been reported on samples from sub-Saharan Africa. Methods: To summarize the performance of the tests using samples from sub-Saharan Africa, we conducted a systematic review of publi- cations reporting performance of commercially available HSV-2 tests against a gold standard (Western Blot or monoclonal antibody-blocking EIA). We used random-effects meta-analyses to summarize sensitivity and specificity of the 2 most commonly evaluated tests, Kalon gG2 enzyme-linked immunosorbent assay (ELISA), and Focus HerpeSelect HSV-2 ELISA. Results: We identified 10 eligible articles that included 21 studies of the performance of Focus, and 12 of Kalon. The primary analyses included studies using the manufacturers' cut-offs (index value = 1.1). Focus had high sensitivity (random effects summary estimate 99%, 95% confidence interval [CI]: 99%-100%) but low specificity (69%, 95% CI: 59%- 80%). Kalon had sensitivity of 95% (95% CI: 93%- 97%) and specificity of 91% (95% CI: 86%-95%). Specificity of Focus was significantly lower ( P = 0.002) among HIV-positive (54%, 95% CI: 40%- 68%) than HIV-negative individuals (69%, 95% CI: 56%- 82%). When the cut-off optical density index was increased above the recommended value of 1.1 to between 2.2 and 3.5, the specificity of Focus increased to 85% (95% CI: 77%-92%). Conclusions: Sensitivity and specificity of HSV-2 tests used in sub-Saharan Africa vary by setting, and are lower than reported from studies in the United States and Europe. Increasing the cut-off optical density index may improve test performance. Evaluation of test per- formance in a given setting may help deciding which test is most appropriate.enArticle