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Field evaluation of alternative testing strategies for diagnosis and differentiation of HIV-1 and HIV-2 infections in an HIV-1 and HIV-2-prevalent area.

Authors
  • Andersson, S1
  • da Silva, Z
  • Norrgren, H
  • Dias, F
  • Biberfeld, G
  • 1 Swedish Institute for Infectious Disease Control, Stockholm, Sweden. , (Sweden)
Type
Published Article
Journal
AIDS
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Dec 01, 1997
Volume
11
Issue
15
Pages
1815–1822
Identifiers
PMID: 9412699
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Western blot (WB) is the most widely used serological confirmatory test of ELISA and rapid simple tests (RST) to detect infection with HIV. WB tests, however, are expensive, time-consuming, and have technical disadvantages. The authors therefore conducted a study to identify cost-efficient alternative strategies for HIV-antibody screening, confirmation, and discrimination of HIV-1 and HIV-2 infections in a HIV-1 and HIV-2 prevalent area. 1110 consecutively collected blood sera from Guinea-Bissau were included in the first phase of the study, of which 198 (17.8%) were known to be HIV-seropositive; 52 with HIV-1, 120 with HIV-2, and 26 being HIV-1/HIV-2 dually reactive. 95 selected HIV-positive specimens were included for study of sensitivity and cross-reactivity between HIV-1 and HIV-2, with WB used to confirm specimen reactivity. All specimens were screened by Enzygnost ELISA and Capillus RST, with reactive samples further tested by the following assays for confirmation: UBI ELISA, Innotest ELISA, Recombigen RST, Multispot RST, and Immunocomb RST. The confirmatory RST, Wellcozyme Recombinant HIV-1 ELISA, PEPTI-LAV, and INNO-LIA were also used to study differentiation between HIV-1 and HIV-2. All assays were 100% sensitive. The specificities of the screening assays at initial and repeated testing were 98.0% and 99.7%, respectively, for Enzygnost and 99.8% and 99.9%, respectively, for Capillus. Various combinations of 2-3 assays yielded specificities of 99.2-100%. Screening with Enzygnost ELISA and confirmation and differentiation between HIV-1 and HIV-2 with Capillus RST and Multispot RST was adopted for routine use at Guinea-Bissau's National Public Health Laboratory. A field trial of the approach conducted in 1996 involving 1501 sera found a sensitivity and specificity comparable to ELISA and WB.

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