Comparison of the sensitivity of various anti-HIV tests in early seroconversion sera

Paired sera from 4 patients with proven HIV infection whose initial specimens obtained 14-51 days earlier were indeterminate were simultaneously retested with 7 screening anti-HIV test kits and the immunoblot assay. The study aimed to evaluate the sensitivity of various new and old anti-HIV screening tests. The test kits evaluated were 4 ELISA test kits from Wellcome (Wellcozyme), Organon (Vironostika anti-HTLV-III), Pasteur (Rapid Elavia) and Diagnostic Biotechnology (DB, HIV-1 ELISA), 2 rapid tests based on microfiltration enzyme immunoassay procedure from Rapport (SUDS) and Disease Detection International (SeroCard), and 1 particle agglutination (PA) test (Serodia-HIV). Immunoblot strips from Diagnostic Biotechnology (HIV-1 Western blot) were used to confirm the HIV infection in these serum specimens. Out of the 4 initial serum specimens tested, all were positive by PA, 2 by SUDS, Wellcome and Pasteur, 1 by SeroCard and DB, and none by Organon. When tested by immunoblot, 1 was negative (i.e., completely without any bands) whereas 3 were indeterminate (i.e., 1 with very weak band for p18, 1 with weak band for p24, 1 with very weak band for gp160. All repeat specimens obtained 14-51 days later (mean 32.5 +/- 16 days) were positive by all screening tests as well as immunoblot. Therefore, with these 4 early seroconversion sera, the sensitivity of the PA was 100%, that of SUDS, Wellcome and pasteur was 50%, of that SeroCard and DB was 25%, and Organon, 0%. None of these sera was considered positive by immunoblot.