WHO Prequalification of In Vitro Diagnostics Programme PUBLIC REPORT Product: SURE CHECK HIV 1/2 Assay Number: PQDx 0054-006-00 Abstract SURE CHECK HIV 1/2 Assay with product code HIV201, manufactured by Chembio Diagnostic Systems, Inc. CE-marked regulatory version, was accepted for the WHO list of prequalified in vitro diagnostics and was listed on 8 December 2014. This public report was amended on 04 June 2018 to correct a typographical error. SURE CHECK HIV 1/2 Assay is a single-use immunochromatographic, rapid screening test for the detection of Human Immunodeficiency Virus Types 1 and 2 (HIV1/2) in fingerstick whole blood, venous whole blood, serum or plasma specimens. SURE CHECK HIV 1/2 Assay is intended for use as a point-of-care test to aid in the diagnosis of infection with HIV-1 and HIV-2. This test is suitable for use in multi-test algorithms designed for the statistical validation of rapid HIV test results. When multiple rapid HIV tests are available, this test should be used in appropriate multi-test algorithms for confirmation of reactive results. Each test kit contains the components to perform 25 tests: 1 Product insert for the SURE CHECK HIV ½ assay 1 Disposable Rack for holding Buffer Vials upright 1 Insert for the Disposable Rack 25 pouches, each containing: 1 Sampler with a test strip inside 1 Buffer Vial attached to the sampler (~350 μl) 1 Sterile Lancet 1 Bandage 1 Desiccant Packet Storage: The test kit should be stored between 8 C to 30 C. Shelf-life: 24 months. Page 1 of 15
Summary of prequalification status for SURE CHECK HIV 1/2 Assay Initial acceptance Date Outcome Amended PQ public report 04 June 2018 Listed Status on PQ list 08 December 2014 Listed Dossier assessment 12 August 2014 MR Inspection status 27 November 2014 MR Laboratory evaluation 31 October 2014 MR MR: Meets Requirements SURE CHECK HIV 1/2 Assay was accepted for the WHO list of prequalified in vitro diagnostics on the basis of data submitted and publicly available information. Background information Chembio Diagnostic Systems, Inc. submitted an application for prequalification of SURE CHECK HIV 1/2 Assay. Based on the established prioritization criteria, SURE CHECK HIV 1/2 Assay was given priority for prequalification. Product dossier assessment Chembio Diagnostic Systems, Inc. submitted a product dossier for SURE CHECK HIV 1/2 Assay as per the WHO guidance document Instructions for Compilation of a Product Dossier (PQDx_018 v1). The information submitted in the product dossier was reviewed by WHO staff and external experts (reviewers) appointed by WHO in accordance with the WHO document Internal Report on the Screening and Assessment of a Product Dossier (PQDx_009 v2). Based on the product dossier screening and assessment findings, a recommendation was made to accept the product dossier for SURE CHECK HIV 1/2 Assay for prequalification. Manufacturing site inspection A comprehensive inspection was performed at the site of manufacture (Medford, USA) of SURE CHECK HIV 1/2 Assay test in October 2014 as per the WHO guidance document Information for Manufacturers on Prequalification Inspection Procedures for the Sites of Manufacture of Diagnostics (PQDx_014 v1). The inspection found that the manufacturer had an acceptable quality management system and good manufacturing practices in place that ensured the consistent manufacture of a product of good quality. The manufacturer's responses to the nonconformities found at the time of the inspection were accepted 21 November 2014. Commitment for prequalification: Desiccated pouches/bags used to store in process components will include a humidity indicator card for verification of proper desiccation. Evaluation of the accuracy of the humidity indicator cards and suitability for this purpose shall be performed. (Response to WHO not required). Page 2 of 15
Laboratory evaluation SURE CHECK HIV 1/2 (Chembio Diagnostics System Inc.) was evaluated by WHO in the third quarter of 2014 using serum/plasma specimens. From this evaluation, we drew the following conclusions: SURE CHECK HIV 1/2 (Chembio Diagnostics System Inc.) is an immunochromatographic assay for the detection of HIV-1/2 antibodies in human serum/plasma and whole blood specimens. A volume of 2.5 µl of serum/plasma specimen is required to perform the assay. This type of assay does not require sophisticated equipment and can therefore be performed in laboratories with limited facilities and non-laboratory settings. Reading of the results can be done visually i.e. subjectively read. When using serum or plasma specimens, a precision pipette has to be used to deliver the specimen. In this limited evaluation on a panel of 1118 clinically-derived specimens, we found an initial sensitivity (95% CI) of 99.8% (98.8% - 100%) and an initial specificity (95% CI) of 99.9% (99.2% - 100%) compared to the reference assays. The final sensitivity (95% CI) was 99.8% (98.8% - 100%) and the final specificity (95% CI) was 99.9% (99.2% - 100%) compared to the reference assays. Lot to lot variation was acceptable. For eight seroconversion panels, SURE CHECK HIV 1/2 detected on average 0.25 specimens later than the benchmark assay; Enzygnost Anti-HIV 1/2 Plus (Siemens Healthcare Diagnostics). For the mixed titer panel, SURE CHECK HIV 1/2 correctly classified all anti-hiv negative/hiv-1 antigen negative specimens, all anti-hiv positive/hiv-1 antigen positive specimens and all anti-hiv positive/hiv-1 antigen negative specimens of the HIV mixed titer panel in comparison with the expected results. SURE CHECK HIV 1/2 was not able to detect three out of the six anti-hiv indeterminate/hiv-1 antigen positive specimens. The assay did not detect the anti-hiv negative/hiv-1 antigen positive specimen. For the 1 st International Reference Panel for anti-hiv [NIBSC code 02/210], SURE CHECK HIV 1/2 detected all specimens. In this study, 0% of the results were recorded as indeterminate. Results were interpreted independently by three technicians; the inter-reader variability was 0%. The invalid rate was 0%. Page 3 of 15
Labelling 1. Labels 2. Instructions for use Page 4 of 15
1. Labels Kit Box Label: 10-6173-0 o Kit Box Cover: o Kit Box Side: Page 5 of 15
Pouch (Device) Foil: 10-3517-0 Disposable Rack: 10-6047-0 Page 6 of 15
2. Instructions for use Product Package Insert (IFU): 10-6174-0 Page 7 of 15
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Disposable Rack Package Insert: 10-6236-0 Page 15 of 15