van der Groen G, Van Kerckhoven I, Vercauteren G, Piot P
Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium.
Bull World Health Organ. 1991;69(6):747-52.
The conventional approach to human immunodeficiency virus (HIV) antibody testing, which relies on confirmation of all initially positive screening results using a Western blot assay, is expensive. In an alternative approach, we retested sera that were positive in an initial screening assay using a second screening assay, which differed from the first, and limited the use of Western blot to those sera that gave discrepant results in the two screening assays. This resulted in 100% sensitivity and specificity at a cost that was, on average, 6.1 times less than that of the conventional approach. This level of sensitivity and specificity was also achieved at a cost that was 9.0 times less than the conventional approach if the Western blot was replaced by a third screening assay that differed from the previous two. Retesting positive sera using the same assay did not increase the accuracy of the results obtained by testing the sera only once.
传统的人类免疫缺陷病毒（HIV）抗体检测方法依赖于使用蛋白质印迹法确认所有最初呈阳性的筛查结果，成本高昂。在一种替代方法中，我们使用与第一次不同的第二种筛查试验对初次筛查试验呈阳性的血清进行重新检测，并将蛋白质印迹法的使用限制在两次筛查试验结果不一致的那些血清上。这产生了100%的灵敏度和特异性，成本平均比传统方法低6.1倍。如果用一种与前两种不同的第三种筛查试验取代蛋白质印迹法，在成本比传统方法低9.0倍的情况下也能达到这种灵敏度和特异性水平。使用相同的试验对阳性血清进行重新检测并不会提高仅对血清进行一次检测所获得结果的准确性。
