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What is the best western blot interpretation criteria for the diagnosis of HIV-1 infection? The HIV-2 Spanish Study Group.


Int Conf AIDS. 1992 Jul 19-24;8(3):38 (abstract no. PuA 6164). Unique

OBJECTIVES: The diagnosis of HIV-1 infection usually is done using serological methods. Positive results in screening test are confirmed using more specific assay, and Western blot (WB) is the most frequent used to it. Interpretation of WB reactions is often difficult, even for experienced personnel. Attempts to standardise WB by establishing universal guidelines for reading the strips have been met with only limited success. The CDC and the WHO criteria for interpreting WB results are the most frequent used, but problems remains at all. Herein, we compare the efficacy of several WB interpretation criteria in the diagnosis HIV-1 infection. METHODS: HIV-1 WB analysis was performed in 611 HIV-1 EIA-reactive samples collected from individuals at high-risk for HIV-1 infection during 1991. They corresponded to drug users, homo/bisexual men, African immigrants, and prostitutes. We used a semiquantitative method and only one reader interpret the reactivity in the WB strips (2 as clear positive, 1 as dubious, and 0 as absent). As reference, we used a synthetic peptide assay (SPA) (Pepti-lav, Pasteur) and a recombinant immunoblot assay (RIBA, prototype HIV 1/2 SIA, Ortho). RESULTS: WB results using several WB criteria are summarized in the Table. SPA and RIBA informed positivity to HIV-1 in 581 samples, to HIV-2 in 10, to both HIV-1 and HIV-2 in 6 samples, and not reacted in 14 samples. TABULAR DATA, SEE ABSTRACT VOLUME. CONCLUSIONS: The Consortium for Retrovirus Serology Standardization (CRSS) criteria to interpret WB provide the most sensitive and specific requirements for the diagnosis of the HIV-1 infection. The WHO criteria, as the ARC and the CDC criteria showed a similar efficacy to recognize HIV-1 antibody. The FDA showed the lower sensitivity, and an unexpected number of indeterminate results. Moreover, our data suggest that synthetic peptide or recombinant protein assays provide a better approach than WB to detect HIV-1 infections. These techniques are more specific, economic, and easy to perform than WB. As their sensitivity seems to be excellent, they may be used to confirm the HIV-1 EIA positive results in high-risk individuals.

Blotting, Western/*METHODS/STANDARDS Human HIV Infections/*DIAGNOSIS *HIV-1 *HIV-2 Quality Control Spain ABSTRACT


Information in this article was accurate in December 30, 1992. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.