Bhore A V, Sastry J, Patke D, Gupte N, Bulakh P M, Lele S, Karmarkar A, Bharucha K E, Shrotri A, Pisal H, Suryawanshi N, Tripathy S, Risbud A R, Paranjape R S, Shankar A V, Kshirsagar A, Phadke M A, Joshi P L, Brookmeyer R S, Bollinger R C
Department of Microbiology, BJ Medical College/Sassoon Hospital, Pune, India.
Int J STD AIDS. 2003 Jan;14(1):37-41. doi: 10.1258/095646203321043246.
Efforts to prevent HIV transmission from mother to infants in settings like India may benefit from the availability of reliable methods for rapid and simple HIV screening. Data from India on the reliability of rapid HIV test kits are limited and there are no data on the use of rapid HIV tests for screening of pregnant women.
Pregnant women attending an antenatal clinic and delivery room in Pune agreed to participate in an evaluation of five rapid HIV tests, including (a) a saliva brush test (Oraquick HIV-1/2, Orasure Technologies Inc.), (b) a rapid plasma test (Oraquick HIV-1/2) and (c) three rapid finger prick tests (Oraquick HIV-1/2; HIV-1/2 Determine, Abbott; NEVA HIV-1/2 Cadila). Results of the rapid tests were compared with three commercial plasma enzyme immunoassay (EIA) tests (Innotest HIV AB EIA, Lab systems/ELISCAN HIV AB EIA, UBI HIV Ab EIA).
Between September 2000 and October 1, 2001, 1258 pregnant women were screened for HIV using these rapid tests. Forty-four (3.49%) of the specimens were HIV-antibody-positive by at least two plasma EIA tests. All of the rapid HIV tests demonstrated excellent specificity (96-100%). The sensitivity of the rapid tests ranged from 75-94%. The combined sensitivity and specificity of a two-step algorithm for rapid HIV testing was excellent for a number of combinations of the five rapid finger stick tests.
In this relatively low HIV prevalence population of pregnant women in India, the sensitivity of the rapid HIV tests varied, when compared to a dual EIA algorithm. In general, the specificity of all the rapid tests was excellent, with very few false positive HIV tests. Based upon these data, two different rapid HIV tests for screening pregnant women in India would be highly sensitive, with excellent specificity to reliably prevent inappropriate use of antiretroviral therapy for prevention of vertical HIV transmission.
在印度这样的环境中，预防艾滋病毒母婴传播的努力可能会受益于可靠的快速简易艾滋病毒筛查方法。印度关于快速艾滋病毒检测试剂盒可靠性的数据有限，且尚无关于使用快速艾滋病毒检测筛查孕妇的数据。
在浦那一家产前诊所和产房就诊的孕妇同意参与对五种快速艾滋病毒检测的评估，包括（a）一种唾液刷检法（奥奎克HIV-1/2，奥瑞仕科技公司），（b）一种快速血浆检测法（奥奎克HIV-1/2），以及（c）三种快速指尖采血检测法（奥奎克HIV-1/2；HIV-1/2检测试剂，雅培公司；NEVA HIV-1/2，卡迪拉公司）。将快速检测的结果与三种商业血浆酶免疫测定（EIA）检测法（因诺泰斯特HIV AB EIA、实验室系统/伊丽斯坎HIV AB EIA、泛博HIV抗体EIA）进行比较。
在2000年9月至2001年10月1日期间，使用这些快速检测法对1258名孕妇进行了艾滋病毒筛查。至少两种血浆EIA检测法显示44份（3.49%）标本的艾滋病毒抗体呈阳性。所有快速艾滋病毒检测法均显示出极佳的特异性（96%-100%）。快速检测法的灵敏度范围为75%-94%。对于五种快速指尖采血检测法的多种组合，快速艾滋病毒检测两步法的综合灵敏度和特异性都极佳。
在印度这一艾滋病毒感染率相对较低的孕妇群体中，与双重EIA检测法相比，快速艾滋病毒检测法的灵敏度有所不同。总体而言，所有快速检测法的特异性都极佳，艾滋病毒检测假阳性极少。基于这些数据，印度用于筛查孕妇的两种不同快速艾滋病毒检测法将具有高度敏感性，且特异性极佳，可可靠地防止不恰当地使用抗逆转录病毒疗法来预防艾滋病毒垂直传播。
