Evaluation of HIV serial and parallel serologic testing algorithms in Abidjan, Côte d'Ivoire

Area of Science:

• Virology
• Immunology
• Public Health

Background:

• Human Immunodeficiency Virus (HIV) infection remains a significant global health challenge.
• Accurate and efficient diagnostic algorithms are crucial for HIV surveillance and patient management.
• Prevalence of HIV-2 and non-B subtypes of HIV-1 necessitates robust testing strategies.

Purpose of the Study:

• To evaluate novel HIV serologic testing algorithms utilizing a combination of three enzyme-linked immunosorbent assays (ELISA).
• To assess the efficacy of these algorithms for confirming HIV infection in Abidjan, Côte d'Ivoire.
• To determine if the proposed algorithms are a cost-effective alternative to standard methods.

Main Methods:

• Six ELISA kits were initially screened for sensitivity, specificity, and delta values using 1069 human sera.
• Three selected ELISA kits (Enzygnost, ICE 1.0.2, Vironostika) were employed in parallel and serial algorithms for testing 8283 sera.
• Confirmatory testing using Peptilav and Western blot was performed on selected samples.

Main Results:

• All ELISA kits demonstrated 100% sensitivity, with specificities ranging from 96.8% to 100%.
• The parallel and serial algorithms achieved high sensitivity (100% and 99.96%, respectively) and specificity (99.95% for both).
• The three-ELISA algorithm demonstrated at least a 50% reagent cost saving compared to Peptilav-based algorithms.

Conclusions:

• A combination of ELISA with different principles or antigens in serial or parallel algorithms is effective for HIV confirmation.
• These algorithms offer an efficient and cost-effective alternative to standard testing protocols.
• The findings are particularly relevant for regions with high prevalence of HIV-1 and HIV-2.