Kline R L, Brothers T A, Brookmeyer R, Zeger S, Quinn T C
National Institute of Allergy and Infectious Diseases, Bethesda, Maryland 20892.
J Clin Microbiol. 1989 Jul;27(7):1449-52. doi: 10.1128/jcm.27.7.1449-1452.1989.
The pooling of individual serum samples to determine human immunodeficiency virus (HIV) seropositivity was examined to assess whether testing pooled sera was technically feasible, cost-effective, and accurate for estimating seroprevalence in large population surveys. The sensitivities and specificities of three commercially available HIV enzyme-linked immunosorbent assay (ELISA) kits were tested using 65 serum pools of 15 individual serum samples each (975 total serum samples) at two different dilutions. With pooled sera, the Organon Teknika Bio-EnzaBead ELISA at half the dilution recommended by the manufacturer showed the best agreement with ELISA and Western blot results of individual sera. In subsequently testing 92 pools, each containing 15 individual serum samples from a population of American patients attending a sexually transmitted diseases clinic, the estimated seroprevalence was 5.27 compared with 4.93% in a test of 1,380 individual serum samples and 5.19% in a test of 4,028 individual serum samples from the same population. In an evaluation of 1,380 African patients using 10 serum samples per pool, the estimated seroprevalence was 5.79 compared with 6.16% in a test of individual sera. These results indicate that ELISA testing with pooled sera is highly sensitive and specific and appears to be a cost-effective means for estimating HIV seroprevalence in large population-based surveys.
为评估在大规模人群调查中检测混合血清以估计血清阳性率在技术上是否可行、是否具有成本效益以及是否准确，对用于确定人类免疫缺陷病毒（HIV）血清阳性的个体血清样本混合进行了研究。使用三种市售的HIV酶联免疫吸附测定（ELISA）试剂盒，在两种不同稀释度下，对65个血清池（每个血清池包含15个个体血清样本，共975个血清样本）进行了敏感性和特异性测试。对于混合血清，Organon Teknika Bio-EnzaBead ELISA在制造商推荐稀释度的一半时，与个体血清的ELISA和蛋白质印迹结果显示出最佳一致性。随后对92个血清池进行检测，每个血清池包含来自一家性传播疾病诊所的美国患者群体的15个个体血清样本，估计血清阳性率为5.27%，而对来自同一群体的1380个个体血清样本进行检测时该比例为4.93%，对4028个个体血清样本进行检测时该比例为5.19%。在对1380名非洲患者进行评估时，每个血清池使用10个血清样本，估计血清阳性率为5.79%，而对个体血清进行检测时该比例为6.16%。这些结果表明，使用混合血清进行ELISA检测具有高度敏感性和特异性，似乎是在基于人群的大规模调查中估计HIV血清阳性率的一种具有成本效益的方法。
