       Document 0950
 DOCN  M9440950
 TI    [Alternative strategy for the diagnosis of HIV infection in sub-saharan
       Africa. Value of the sequential combination of the ELISA test and a 2nd
       generation rapid test]
 DT    9404
 AU    Gresenguet G; Tevi-Benissan C; Payan C; Pascal B; Matta M; Dragon MA;
       Belec L; Service de Microbiologie (Virologie), Hopital Broussais,
       Paris,; France.
 SO    Bull Soc Pathol Exot. 1993;86(4):236-42. Unique Identifier : AIDSLINE
       MED/94122551
 AB    The conventional algorithm for HIV testing based on the confirmation of
       all positive anti-HIV screening reactions by Western blot requires
       sufficient laboratory facilities and is expensive, that limits its use
       in developing countries, such as in subsaharian Africa. The apparition
       of second and third generation screening ELISA which are very sensitive
       and specific, as well as the development of rapid tests which are
       simple, visually read, and sufficiently sensitive and specific, has
       permitted the design of alternative strategy for HIV testing utilizing
       the association of 2 ELISA and/or rapid tests, in order to limit the use
       of a confirmatory assay. Alternative strategies are less expensive,
       yield generally very high sensitivity and specificity, and have proved
       to be valuable for African countries. In this study, 5 alternative
       strategies, using different associations of two second generation
       screening tests, one classical ELISA (Genelavia mixt) and one rapid test
       (Test PACK HIV-1/HIV-2 AB) have been retrospectively evaluated in the
       field in Bangui, Central African Republic, with a panel of 130 sera
       (prevalence of HIV infection: 42.7%). The strategy using two sequential
       screening tests (Test Pack HIV-1/HIV-2 AB following by Genelavia mixt)
       with the confirmation of discordant results by Western blot permitted to
       diagnose HIV-1 infection in Bangui with a sensitivity, a specificity and
       a positive predictive value of 100%, and to reduce the cost of more than
       50% in comparison with the conventional strategy. Such an alternative
       strategy could be useful for the individual notification of HIV serology
       in Bangui.
 DE    Adult  *Algorithms  Central African Republic/EPIDEMIOLOGY  Comparative
       Study  *Developing Countries  English Abstract  Enzyme-Linked
       Immunosorbent Assay/ECONOMICS/*METHODS  Evaluation Studies  Female
       Human  HIV Infections/*BLOOD/EPIDEMIOLOGY/PREVENTION & CONTROL  *HIV
       Seroprevalence  *HIV-1  Immunoblotting/ECONOMICS/*METHODS  Male  Mass
       Screening/ECONOMICS/*METHODS  Retrospective Studies  Sensitivity and
       Specificity  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

