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Related Experiment Videos

HIV screening and confirmation: a simplified and less expensive testing algorithm.

J Nkengasong1, I Van Kerckhoven, G Carpels

  • 1Department of Infection & Immunity, Institute of Tropical Medicine, Antwerpen, Belgium.

Annales De La Societe Belge De Medecine Tropicale
|June 1, 1992
PubMed
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This study evaluated combined screening assays (CSAs) for HIV-1 and HIV-2 antibody detection. Certain CSA pairs offer accurate, cost-effective HIV testing, reducing reliance on Western blot (WB) confirmation.

Area of Science:

  • Clinical diagnostics
  • Virology
  • Immunology

Background:

  • Human Immunodeficiency Virus (HIV) infection requires accurate and accessible diagnostic methods.
  • Combined screening assays (CSAs) simultaneously detect antibodies to HIV-1 and HIV-2.
  • Evaluating the performance of different CSAs is crucial for optimizing HIV testing algorithms.

Purpose of the Study:

  • To assess the performance of fourteen combined screening assays (CSAs) for detecting HIV-1 and HIV-2 antibodies.
  • To compare an alternative HIV testing algorithm using pairs of CSAs against the conventional Western blot (WB) confirmation method.
  • To identify optimal CSA combinations balancing sensitivity, specificity, cost, and testing time.

Main Methods:

  • Evaluated 14 CSAs (9 ELISAs, 5 non-ELISAs) using 371 sera with varying HIV prevalence and geographic origins.

Related Experiment Videos

  • An alternative algorithm involved retesting initial CSA-positive sera on a second, different CSA.
  • Western blot (WB) was used for discrepant results (CSA A+B-) and confirmation.
  • Performance metrics included sensitivity, specificity, cost, and delta values.

    • Main Results:

    • All ELISAs achieved 100% sensitivity; non-ELISAs ranged from 96.0% to 100%.
    • Specificity varied: ELISAs (87.4%-100%), non-ELISAs (51.4%-100%).
    • Nine (7.4%) CSA pairs demonstrated 100% sensitivity and specificity.
    • The alternative algorithm using selected CSA pairs was significantly faster and less expensive than conventional WB confirmation.

    Conclusions:

    • Several combinations of CSAs can be effectively employed in an alternative HIV testing algorithm.
    • This alternative approach provides accurate results at a substantially lower cost and faster turnaround time.
    • Optimized CSA pairs can reduce the need for universal WB confirmation, improving efficiency in HIV diagnostics.