[Screening of HIV in blood banks. Evaluation of fourth generation kits]
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Published on: November 1, 2010
Fernando Canna1, Elena Treviño, Claudia Domínguez
1Laboratorio de Virus Linfotrópicos Humanos, Instituto de Virología Dr. José María Vanella, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina. sgallego@cmefcm.uncor.edu
Insights
The 4th generation EIA is a cost-effective alternative for HIV screening in blood banks, offering comparable sensitivity to 3rd generation EIA and p24Ag tests. This approach enhances effectiveness and reduces costs for HIV detection.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- The Argentinean Society of Hemotherapy and Immunohematology recommends p24 antigen (p24Ag) tests for HIV screening in blood banks.
- Implementation of p24Ag screening in Argentina has increased costs without yielding expected benefits.
Purpose of the Study:
- To evaluate a 4th generation enzyme immunoassay (EIA) for HIV screening.
- To compare its performance against existing 3rd generation EIA and p24Ag assays used in a blood bank setting.
Main Methods:
- A comparative study involving 11 early HIV infection samples, 27 asymptomatic HIV-infected samples, and 39 non-HIV infected samples.
- Evaluation of 3rd generation EIA, 4th generation EIA, and p24Ag assay performance.
Main Results:
- Both 3rd and 4th generation EIAs demonstrated 100% sensitivity.
- 3rd generation EIA showed higher specificity (97.5%) than 4th generation EIA (95.1%).
- The p24Ag test missed 2 early HIV infection cases.
Conclusions:
- Both 3rd and 4th generation EIAs perform well for HIV screening.
- The 4th generation EIA offers a lower-cost alternative, potentially improving cost-effectiveness in regional blood banks.
- Transition to 4th generation EIA can enhance screening effectiveness and reduce costs pending HIV RNA implementation.
Abstract:
Use of detection tests for p24 HIV antigen (p24Ag) in blood banks in Argentina is recommended by the Argentinean Society of Hemotherapy and Immunohematology. In the blood bank of the National University of Cordoba (Argentina), the recent implementation of the p24Ag screening test has considerably increased the cost of the battery of screening tests and its use in all blood donations has not produced the benefits expected. A 4th generation EIA was evaluated for the screening of HIV in comparison with the currently used assays in the blood bank of National University of Cordoba (3rd generation EIA + p24Ag assay). For this comparison, 11 serum samples from subjects with early HIV infection (early seroconversion period) were tested, as well as 27 serum samples from asymptomatic HIV-infected subjects and other 39 from non-HIV infected subjects. The 3rd generation EIA and the 4th generation EIA showed the same sensitivity value (100%) but the specificity of the 3rd generation EIA was higher (97.5%) comparing with 4th generation (95.1%). Besides, the p24Ag test failed to detect 2 samples from subjects with early HIV infection. These results indicate a good performance of both 3rd and 4th generation assays for screening of HIV. However, due to the lowest cost of 4th generation EIA kit, it could replace the currently used assays for HIV screening in regional blood banks. This screening assay will lead to gain in effectiveness and reduced costs until the detection of HIV RNA can be implemented in blood banks.
