       Document 0030
 DOCN  M9640030
 TI    Evaluation of the World Health Organisation antibody-testing strategy
       for the individual patient diagnosis of HIV infection (strategy III).
 DT    9604
 AU    Martin DJ; Blackburn NK; O'Connell KF; Brant ET; Goetsch EA; MRC AIDS
       Virus Research Unit, National Institute for Virology,; Johannesburg.
 SO    S Afr Med J. 1995 Sep;85(9):877-80. Unique Identifier : AIDSLINE
       MED/96061903
 AB    OBJECTIVE. To evaluate the World Health Organisation (WHO) antibody
       testing strategy for the individual patient diagnosis of HIV infection
       (strategy III). DESIGN. Evaluation of a combination of enzyme-linked
       immunosorbent assays (ELISAs) for the detection of antibodies to HIV-1
       and HIV-2 infection. The WHO strategy III calls for a combination of
       three ELISAs, based on different antigens and/or differing test
       principles, to be used in a sequential fashion. The first part of the
       study evaluated various kits as part of a selection process. The second
       part of the study was an assessment of the three-ELISA testing strategy
       on routine sera submitted to the National Institute for Virology (NIV)
       for HIV testing. In all instances, the conventional testing protocol,
       which utilises a screening ELISA followed by a confirmatory Western blot
       (WB) on positive specimens, was used as the 'gold standard'. SETTING.
       The HIV-testing laboratory at the NIV, Johannesburg. RESULTS. In the
       first part of the study, all of the ELISA kits evaluated showed high
       sensitivity and specificity, and a selection of the kits for part two of
       the study was made in accordance with the WHO recommendation. The kits
       selected, in order of use, were the Biotest anti-HIV 1/2 (test 1),
       Pasteur Genelavia Mixt HIV-1/2 (test 2) and Murex Wellcozyme HIV-1
       competitive assay (test 3). This combination was evaluated using 7,812
       sera submitted to the NIV for serology testing. The sensitivities of the
       tests were highly satisfactory (99.6-100%) as were the specificities
       (99.2-100%). The positive predictive value of strategy III at various
       seroprevalence (0.5-25.5%) was > or = 99.6%. The rate of WB usage when
       compared with the previous HIV testing protocol was low (4.6%).
       CONCLUSIONS. The results of this study suggest that this testing
       protocol could be introduced in South Africa with considerable
       cost-saving and no reduction in specificity.
 DE    *Enzyme-Linked Immunosorbent Assay/METHODS  Evaluation Studies  Human
       HIV Antibodies/*BLOOD  HIV Infections/*DIAGNOSIS  Sensitivity and
       Specificity  *World Health Organization  JOURNAL ARTICLE

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

