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Published on: September 14, 2014
HIV-antibody detection in children by competitive and direct micro-ELISA techniques
C Voiculescu1, A Turculeanu, M Bălăşoiu
1Faculty of Medicine, Department of Microbiology, Craiova, Romania.
Insights
This study compared direct and competitive micro-ELISA kits for HIV antibody detection in infants. Wellcozyme and Rapid Elavia Mixt kits showed high sensitivity and specificity, outperforming others for reliable HIV screening.
Area of Science:
- Immunology
- Virology
- Diagnostic Assays
Background:
- Accurate human immunodeficiency virus (HIV) antibody detection is crucial in pediatric populations.
- Micro-ELISA assays are widely used for initial HIV screening.
- Comparative analysis of different assay systems is essential for optimizing diagnostic strategies.
Purpose of the Study:
- To compare the performance of four direct micro-ELISA and one competitive micro-ELISA system for HIV antibody detection in infants.
- To evaluate the sensitivity and specificity of these assays against Western Blot confirmation.
- To investigate serological marker changes in severe HIV cases with undetermined Western Blot results.
Main Methods:
- A comparative study involving 110 infant sera suspected of HIV infection.
- Utilized four direct micro-ELISA kits (Wellcozyme HIV 1+2, Rapid Elavia Mixt, Ortho Diagnostics, RECVIH) and one competitive system (Wellcozyme-Recombinant).
- Assessed sample/cut-off and cut-off/sample ratios, and compared results with Western Blot.
Main Results:
- Three direct systems and the competitive system showed significantly higher mean values compared to RECVIH.
- Wellcozyme (direct and competitive) and Rapid Elavia Mixt kits demonstrated high sensitivity and specificity.
- Ortho Diagnostics and RECVIH kits exhibited lower sensitivity and specificity.
- Observed disappearance of p24 band, HIV-p24 antibody negativation, and presence of free virus antigen in severe cases.
Conclusions:
- Comparative micro-ELISA testing using both direct and competitive systems is valuable for HIV antibody detection.
- Wellcozyme and Rapid Elavia Mixt kits are recommended for reliable HIV screening in infants.
- Changes in serological markers may indicate immune barrier fall in advanced HIV stages.
Abstract:
A comparative study was carried out on 110 sera from children or infants, suspected of HIV-antibody presence following several micro-ELISA assays, using four direct micro-ELISA (Wellcozyme HIV 1 + 2, Rapid Elavia Mixt, Ortho Diagnostics, RECVIH) and a competitive system--Wellcozyme-Recombinant. In three of the four direct systems, as well as in the competitive system, significantly higher mean values of sample/cut off, and cut off/sample ratios, respectively, as compared to the direct systems RECVIH, were present. High optimal levels of sensitivity and specificity (%), as related to Western Blot results, were found with Wellcozyme direct and competitive kits, as well as with Rapid Elavia Mixt kit, as compared to lower levels exhibited by the other two direct system kits (Ortho Diagnostics an especially RECVIH). As regards three Western Blot undetermined results, obtained in patients with a severe clinical state and evolution to exitus, by comparing some serological markers of HIV infection in two serum samples belonging to the same case (second sample collected 4 weeks after collection of the first homologous sample), the disappearance of gag-encoded-p24 band in Western Blot, associated with negativation of HIV-p24-antibody and with the presence of free virus antigen in all three second serum samples occurred, that would reflect a probable fall of immune anti-HIV "barriers" during final stages of illness. Although Western Blot confirmation cannot be excluded, it seems to be useful to assay comparatively HIV-antibody presence by means of direct and competitive micro-ELISA systems, in the same serum sample.
