Moon Hee-Won, Huh Hee Jin, Oh Gwi Young, Lee Sang Gon, Lee Anna, Yun Yeo-Min, Hur Mina
Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea.
Department of Laboratory Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
PLoS One. 2015 Sep 30;10(9):e0139169. doi: 10.1371/journal.pone.0139169. eCollection 2015.
Recently updated recommendations for diagnosis of HIV infection suggest a new diagnostic algorithm including HIV-1/HIV-2 antibody differentiation immunoassay instead of western blot (WB) as a confirmatory testing. We evaluated Bio-Rad Geenius HIV1/2 confirmation assay as a simple and reliable alternative to WB in the Korean population with low HIV prevalence. The Geenius HIV1/2 was performed in a total of 192 serum specimens (140 reactive and 52 nonreactive specimens by ARCHITECT HIV Ag/Ab Combo assay) that were prospectively collected from five institutions. HIV-1 nucleic acid amplification test (NAT) was performed in negative or indeterminate specimens by Geenius HIV1/2 or WB. Among 140 reactive specimens by HIV Ag/Ab assay, 82 (58.6%) were positive for HIV-1 Ab by Geenius HIV1/2. Among 58 negative or indeterminate specimens by Geenius HIV1/2, four specimens (6.9%) were positive by HIV-1 NAT. The sensitivity and specificity of Geenius HIV1/2 were 95.3% and 100.0%, respectively. When we considered only WB, the sensitivity and specificity of Geenius HIV1/2 were 100.0% and 99.1%, respectively. Agreement between Geenius HIV1/2 and WB was excellent (weighted Kappa = 0.89). The Geenius HIV1/2 is simple and time-saving compared with WB. It has an excellent performance and can be a reliable alternative to WB. HIV-1 NAT should be performed in negative or indeterminate specimens by Geenius HIV1/2 to detect acute HIV infection as recommended in new HIV testing algorithms.
最近更新的HIV感染诊断建议提出了一种新的诊断算法,包括采用HIV-1/HIV-2抗体鉴别免疫测定法替代免疫印迹法(WB)作为确证检测方法。我们评估了Bio-Rad Geenius HIV1/2确证检测法,以确定其在HIV感染率较低的韩国人群中作为WB的一种简单可靠替代方法的可行性。对前瞻性收集自五个机构的总共192份血清标本(采用ARCHITECT HIV抗原/抗体联合检测法检测,其中140份反应性标本和52份非反应性标本)进行了Geenius HIV1/2检测。对经Geenius HIV1/2或WB检测呈阴性或不确定的标本进行了HIV-1核酸扩增检测(NAT)。在140份经HIV抗原/抗体检测呈反应性的标本中,82份(58.6%)经Geenius HIV1/2检测HIV-1抗体呈阳性。在58份经Geenius HIV1/2检测呈阴性或不确定结果的标本中,4份(6.9%)经HIV-1 NAT检测呈阳性。Geenius HIV1/2的敏感性和特异性分别为95.3%和100.0%。仅考虑WB时,Geenius HIV1/2的敏感性和特异性分别为100.0%和99.1%。Geenius HIV1/2与WB之间的一致性极佳(加权Kappa = 0.89)。与WB相比,Geenius HIV1/2操作简单且省时。其性能优异,可作为WB的可靠替代方法。按照新的HIV检测算法的建议,对于经Geenius HIV1/2检测呈阴性或不确定的标本,应进行HIV-1 NAT检测以发现急性HIV感染。