Algorithms for detecting antibodies to HIV-1: results from a rural Ugandan cohort.
OBJECTIVE
To evaluate an algorithm using two enzyme immunoassays (EIA) for anti-HIV-1 antibodies in a rural African population and to assess alternative simplified algorithms.


METHODS
Sera obtained from 7895 individuals in a rural population survey were tested using an algorithm based on two different EIA systems: Recombigen HIV-1 EIA and Wellcozyme HIV-1 Recombinant. Alternative algorithms were assessed using negative or confirmed positive sera.


RESULTS
None of the 227 sera classified as unequivocably negative by the two assays were positive by Western blot. Of 192 sera unequivocably positive by both assays, four were seronegative by Western blot. The possibility of technical error cannot be ruled out in three of these. One of the alternative algorithms assessed classified all borderline or discordant assay results as negative had a specificity of 100% and a sensitivity of 98.4%. The cost of this algorithm is one-third that of the conventional algorithm.


CONCLUSIONS
Our evaluation suggests that high specificity and sensitivity can be obtained without using Western blot and at a considerable reduction in cost.
Nunn
A J
AJ
Medical Research Council Programme on AIDS in Uganda, Uganda Virus Research Institute, Entebbe.
Biryahwaho
B
B
Downing
R G
RG
van der Groen
G
G
Ojwiya
A
A
Mulder
D W
DW
D000465:Algorithms; D015153:Blotting, Western; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000453:epidemiology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques; D012680:Sensitivity and Specificity; D014454:Uganda / Q000453:epidemiology
D015483:HIV Antibodies