Usefulness of enzyme immunoassay (EIA) for screening of anti HIV antibodies in urinary specimens: A comparative analysis.
BACKGROUND
Standard HIV testing is done using serum or plasma. FDA approved ELISA to screen urine for IgG antibodies to HIV-1 in 1996. It is a simple, noninvasive test and is appropriate for developing countries where health care personnel may not be professionally trained or where clean needles for drawing blood may not always be available.


METHODS
436 individuals with high-risk behavior and strong clinical suspicion of HIV infection were screened for IgG antibodies to HIV-1 in urine by ELISA. Urine HIV testing was performed by enzyme immunoassay, at the ongoing Voluntary Confidential Counseling and Testing Center (VCCTC) at a large tertiary care microbiology lab. The individuals enrolled for the study had high-risk exposure to the virus and majorities were from a state with a high incidence of HIV infection. In all individuals, both serum and urine were tested for IgG antibodies to HIV-1.


RESULTS
Overall, 135 individuals (30.96%) were HIV-positive, of whom 96 (71%) had never previously tested positive; 87% of those who tested positive received their results, and most were referred for medical care. Sensitivity, specificity and predictive values of HIV-1 urine ELISA test kit were determined. Sensitivity was found to be 89.6%; 95% CI [82.9-94.0], specificity 97.3%; 95% CI [94.6-98.8], positive predictive value 93.8%; 95% CI [87.8-97.1] and negative predictive value 95.4%; 95% CI [92.3-97.4].


CONCLUSIONS
Efficiency, sensitivity, and specificity of the urine-based screening for HIV-1 test kits were excellent as compared to the reference test.
Professor & Head, Dept of Microbiology, Armed Forces Medical College, Pune 411040, India.
A K
AK
Sahni
Professor & Head (Microbiology), Dr Ulhas Patil Medical College, Jalgaon, India.
A
A
Nagendra
Associate Professor, Dept of Microbiology, Armed Forces Medical College, Pune 411040, India.
Partha
P
Roy
Lecturer in Statistics and Demography, Dept of Community Medicine, Armed Forces Medical College, Pune 411040, India.
S
S
Patrikar
Diagnosis of HIV infection; HIV test; Urine testing