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Human immunodeficiency virus type II (HIV-2) testing: a perspective.

¹Department of Pathology, Vanderbilt University, Nashville, TN 37232.

Annals of Clinical and Laboratory Science

|September 1, 1992

Summary

Testing for human immunodeficiency virus type 2 (HIV2) antibodies in blood donors is now available. However, current HIV1 tests detect only 60-90% of HIV2 cases, and the benefits to the blood supply are still under evaluation.

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Area of Science:

Virology
Immunology
Public Health

Background:

Blood screening for human immunodeficiency virus type 2 (HIV2) antibodies has been initiated.
A key advantage is the potential to remove geographic exclusions for blood donors.
Existing anti-human immunodeficiency virus type 1 (HIV1) assays show limited efficacy in detecting HIV2 antibodies.

Purpose of the Study:

To evaluate the utility and effectiveness of newly available HIV2 antibody testing in blood donation screening.
To assess the impact of HIV2 testing on blood supply safety and donor management.

Main Methods:

Review of available diagnostic tests, including a Food and Drug Administration (FDA)-licensed HIV1/HIV2 antibody enzyme immunoassay (EIA) and an unlicensed HIV-2 Western Blot (WB) test.
Analysis of reported detection rates of HIV2 antibodies by existing anti-HIV1 screening methods.

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Consideration of HIV2 prevalence data in U.S. blood donor populations.

Main Results:

Current anti-HIV1 testing detects only 60-90% of samples containing HIV2 antibodies.
Specificity and sensitivity data for HIV2 EIA and HIV2 WB tests are not well-established.
A survey of 24 million U.S. donors detected no HIV2 antibodies, suggesting a very low incidence.

Conclusions:

The low incidence of HIV2 infection implies that most positive results from current screening may be false positives, causing undue anxiety for donors.
The actual benefits of implementing HIV2 antibody testing for the overall blood supply require further evaluation.
Counseling is essential for blood donors receiving positive test results.