{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T12:22:55Z","timestamp":1794572575189,"version":"4.9.1"},"reference-count":14,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction:\u00a0Determining the HIV status of some individuals remains challenging due to multidimensional factors such as flaws in diagnostic systems, technological challenges, and viral diversity. This report pinpoints challenges faced by the HIV testing system in Cameroon.\n\nCase presentation:\u00a0A 53-year-old male received a positive HIV result by a rapid testing algorithm in July 2016. Not convinced of his HIV status, he requested additional tests. In February 2017, he received a positive result using ImmunoComb\u00ae\u00a0II HIV 1 &amp; 2 BiSpot and Roche cobas electrochemiluminescence assays. A sample sent to France in April 2017 was positive on the Bio-Rad GenScreen\u2122 HIV 1\/2, but serotyping was indeterminate, and viral load was &lt; 20 copies\/mL. The Roche electrochemiluminescence immunoassay and INNO-LIA HIV I\/II Score were negative for samples collected in 2018. A sample collected in July 2019 and tested with VIDAS\u00ae\u00a0HIV Duo Ultra enzyme-linked fluorescent assay and Geenius\u2122 HIV 1\/2 Confirmatory Assay was positive, but negative with Western blot; CD4 count was 1380 cells\/mm3\u00a0and HIV proviral DNA tested in France was \u2018target-not-detected\u2019. Some rapid tests were still positive in 2020 and 2021. Serotyping remained indeterminate, and viral load was \u2018target-not-detected\u2019. There were no self-reported exposure to HIV risk factors, and his wife was HIV-seronegative.\n\nManagement and outcome:\u00a0Given that the patient remained asymptomatic with no evidence of viral replication, no antiretroviral therapy was initiated.\n\nConclusion:\u00a0This case highlights the struggles faced by some individuals in confirming their HIV status and the need to update existing technologies and develop an algorithm for managing exceptional cases.<\/jats:p>","DOI":"10.4102\/ajlm.v12i1.1974","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T04:51:33Z","timestamp":1675227093000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Challenges faced by the HIV testing system in low- and middle-income countries"],"prefix":"10.4102","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6354-1400","authenticated-orcid":false,"given":"Rachel 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Research on HIV\/AIDS Prevention and Management"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2896-0508","authenticated-orcid":false,"given":"Aubin","family":"Nanfack","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01a84bt29","id-type":"ROR","asserted-by":"publisher"}],"name":"Centre International De Reference Chantal Biya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1501-2763","authenticated-orcid":false,"given":"Joseph","family":"Fokam","sequence":"additional","affiliation":[{"name":"Chantal Biya International Reference Centre for Research on HIV\/AIDS Prevention and 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[cited 2021 Oct 16]. Available from: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/UNAIDS_FactSheet_en.pdf"},{"key":"ref1","unstructured":"UNAIDS issues new fast-track strategy to end AIDS by 2030 \u2013 EGPAF [homepage on the Internet]. Elizabeth Glaser Pediatric AIDS Foundation; 2014 [cited 2021 Mar 26]. Available from: https:\/\/www.pedaids.org\/2014\/11\/20\/unaids-issues-new-fast-track-strategy-to-end-aids-by-2030\/"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Nkengasong JN, Yao K, Onyebujoh P. Laboratory medicine in low-income and middle-income countries: Progress and challenges. Lancet. 2018;391(10133):1873\u20131875. https:\/\/doi.org\/10.1016\/S0140-6736(18)30308-8","DOI":"10.1016\/S0140-6736(18)30308-8"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Ragupathy V, Zhao J, Wood O, et al. Identification of new, emerging HIV-1 unique recombinant forms and drug-resistant viruses circulating in Cameroon. 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