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[Controversies, difficulties and changes in serological confirmatory testing].

András Zóka1, Márton Gönczi1, András Baráth1

  • 11 Dél-pesti Centrumkórház, Országos Hematológiai és Infektológiai Intézet, Központi Laboratórium, Mikrobiológiai Profil 1097 Budapest, Albert Flórián út 5-7. Magyarország.

Orvosi Hetilap
|December 31, 2023
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Summary

Confirmatory testing is crucial for accurate diagnosis, but evolving laboratory methods for infections like hepatitis B and HIV challenge traditional algorithms. This review addresses these changes to improve clinician-laboratory communication.

Keywords:
MeSH (medical subject heading)MeSH (orvostudományi tárgyszógyűjtemény)immunoassayneutralization testsneutralizáló vizsgálatokserologic testsszerológiai vizsgálatok

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Area of Science:

  • Clinical diagnostics and infectious disease serology.
  • Laboratory medicine and diagnostic assay development.
  • Epidemiology and public health microbiology.

Background:

  • Advances in diagnostic technologies and sero-epidemiological trends necessitate updated testing algorithms.
  • Discrepancies between assay capabilities and clinical expectations create challenges in interpreting laboratory results.
  • The importance of confirmatory testing is underscored by diagnostic significance and screening assay specificity.

Purpose of the Study:

  • To review the evolving landscape of confirmatory testing for key infectious diseases.
  • To analyze the capabilities, limitations, and appropriate applications of current diagnostic assays.
  • To address common controversies in testing algorithms and result interpretation for hepatitis B virus, Hepacivirus hominis, human immunodeficiency virus, and Borrelia burgdorferi.

Main Methods:

  • Review of recent changes in testing algorithms for specific viral and bacterial infections.
  • Analysis of commercially available diagnostic assays and their performance characteristics.
  • Examination of sero-epidemiological data and molecular testing advancements.

Main Results:

  • Significant shifts in testing strategies have occurred due to new technologies and epidemiological patterns.
  • Current diagnostic assays and clinical practices have not always kept pace with these advancements.
  • Difficulties in the clinician-laboratory dialogue persist regarding optimal testing and interpretation.

Conclusions:

  • A comprehensive understanding of updated testing algorithms and assay limitations is essential.
  • Improved communication between clinicians and laboratories is vital for accurate diagnosis and patient management.
  • This review provides guidance on the appropriate application of confirmatory tests for common infections.