AIDSWEEKLY Plus; Monday, November 29, 2004
Staff Medical Writers

"We evaluated a two-rapid-test serial algorithm using the Determine and Genie 11 rapid assays, performed on-site in four peripheral laboratories during the French Agence Nationale de Recherches sur le SIDA (ANRS) 1201/1202 Ditrame Plus cohort developed for prevention of mother-to-child transmission of human immunodeficiency virus (HIV) infection in Me d'Ivoire," investigators in Cote Ivoire report.

A total of 1,039 specimens were retested by two commercial enzyme-linked immunosorbent assays (ELISAs).

"The following specimens were tested: 315 specimens found on-site to be infected with HIV type 1 (HIV-1), 8 specimens found on-site to be infected with HIV-2, 71 specimens found on-site to be infected with both HIV-1 and HIV-2, 40 specimens found on-site to have indeterminate results for HIV infection, and 605 specimens taken during a quality assurance program," wrote F. Rouet and coworkers.

"For HIV discrimination," said the authors, "99 positive serum samples (20 with HIV-1, 8 with HIV-2, and 71 with HIV-1 and HIV-2 on the basis of our rapid test algorithm) were retested by the Peptilav test, Western blot (WB) assays, and homemade monospecific ELISAs. Real-time DNA PCRs for the detection of HIV-1 and HIV-2 were performed with peripheral blood mononuclear cells from 35 women diagnosed on-site with HIV-1 and HIV-2 infections."

"Compared to the results of the ELISAs, the sensitivities of the Determine and Genie H assays were 100% (95% lower limit [95% LL], 99.1%) and 99.5% (95% confidence interval [95% CI], 98.2 to 99.9%), respectively. The specificities were 98.4% (95% CI, 96.9 to 99.3%) and 100% (95% LL, 99.3%), respectively. All serological assays gave concordant results for infections with single types.

"By contrast, for samples found to be infected with dual HIV types by the Genie H assay," the authors continued, "dual reactivity was detected for only 37 samples (52.1%) by WB assays, 34 samples (47.90%) by the Peptilav assay, and 23 samples (32.4%) by the monospecific ELISAs.

"For specimens with dual reactivity by the Genie H assay, the rates of concordance between the real-time PCR assays and the serological assays were 25.7% for the Genie H assay, 82.9% for the Peptilav assay, 74.3% for WB assays, and 80% for the homemade ELISAs."

Rouet concluded, "Our algorithm provided high degrees of sensitivity and specificity comparable to those of ELISAs. Even if they are rare, women identified by the Genie II assay as being infected with HIV-1 and HIV-2 mostly appeared to be infected only with HIV-2."

Rouet and colleagues published their study in the Journal of Clinical Microbiology (Field evaluation of a rapid human immunodeficiency virus (HIV) serial serologic testing algorithm for diagnosis and differentiation of HIV type 1 (HIV-1), HIV-2, and dual HIV-1-HIV-2 infections in west African pregnant women. J Clin Microbiol. 2004 Sep;42(9):4147-53.

For additional information, contact F. Rouet, CHU Treichville, Programme PAC CI, BP V3, Abidjan, Cote Ivoire.

The publisher of the Journal of Clinical Microbiology can be contacted at: American Society Microbiology, 1752 N St. NW, Washington, DC 20036-2904, USA.

The information in this article comes under the major subject areas of HIV/AIDS, Diagnostics, Genomics and Genetics, Immunology, and Obstetrics.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Rouet F, Ekouevi DK, Inwoley A, et al., "Field evaluation of a rapid human immunodeficiency virus (HIV) serial serologic testing algorithm for diagnosis and differentiation of HIV type 1 (HIV-1), HIV-2, and dual HIV-1-HIV-2 infections in West African pregnant women", J Clin Microbiol. 2004 Sep;42(9):4147-53.

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