Prevalence of HIV infection in the Philippines remains low. This may be partly due to reliance on passive reporting for surveillance. The algorithm for laboratory testing for HIV infection has become more stringent in the sense that the screening assays are repeated in the confirmatory centers, before Western Blot is performed. This has been due to the high rate of false positives before 2005. Nucleic Acid Amplification testing (NAAT) has been performed routinely for blood banking purposes in other countries. In a few pilot studies, it has proven useful in identifying those cases in the early stage of the infection, which are missed on testing by antibody-based assays. The assay may prove useful in knowing whether false negatives happen with the current testing algorithm in the Philippines. Coupled with the detuned assay, identification of new cases may be critical for prevention of transmission, surveillance of cases, and early medical management if needed.

Hiv Infections ; Prevalence ; Philippines ; Blood Banks ; Blotting, Western ; Antibodies ; Nucleic Acid Amplification Techniques ; Algorithms ; Nucleic Acids

Objective: This study aimed to determine the accuracy, sensitivity and specificity of frozen section (FS) in the diagnosis of uterine neoplasm in a tertiary government training hospital. Methodology: This is a retrospective validation study from 2004-2015 involving cases of uterine lesions from gynecologic surgeries. All histopathologic results of frozen and paraffin sections were retrieved and reviewed. Chi square test with 2x2 Fischer Exact test adjustment was used to check for associations. Accuracy indices of FS tool were estimated such as sensitivity, specificity, likelihood ratios, negative and positive predictive values, and overall accuracy. A p-value of < 0.05 alpha is considered significant. Results: A total of 143 uterine specimens were submitted for frozen section analysis. The utilization rate of FS is 1% per year. The FS results were correlated with the final histopathologic diagnosis with 96% agreement rate. Utilizing a median number of 3 sections per specimen provides an overall accuracy rate of 97%. The accuracy rate of FS is equal between combined benign-premalignant and malignant cases at 96%. The accuracy rate is not statistically affected by the procedure by which the specimen was taken, as well as the source and gross morphology of the specimen. Moreover, a minimum of 11 sections per specimen is needed to obtain an accuracy rate of 99-100%. The accuracy rate particularly for endometrial lesions is between 94 and 100%. Conclusion Accuracy rates of frozen section on uterine lesions are high regardless of the sampling procedure and source of the specimen. Increasing the number of sections during FS parallels that of the final histopathologic diagnosis. FS for uterine lesions is a vital and cost-effective intraoperative decision tool to maximize care of patients.
Frozen Sections