Ory H W, Koplan J P, Allen J R
Isr J Med Sci. 1986 Jul-Aug;22(7-8):524-8.
Screening for disease control can be defined as a preventive technology that is used to examine asymptomatic people in order to classify them as likely or unlikely to have the disease that is the object of screening. Screening may consist of routine physical examinations, radiologic procedures, semi-invasive procedures such as endoscopy, or serologic tests. In this paper, a new serologic test is considered. Acquired immunodeficiency syndrome (AIDS) is a devastating disease with high mortality, recently shown to be caused by a retrovirus named human T-lymphotropic virus Type III (HTLV-III) or lymphadenopathy-associated virus HTLV-III antibody in serum specimens. Performance characteristics are excellent with high sensitivity and specificity when reactive serum specimens are checked for consistency of response by enzyme immunoassay (EIA). This test is now part of the screening protocol for all blood donation centers to decrease the risk of HTLV-III transmission via blood or blood products. About 0.2% (1 in 400) of blood donors have repeatedly reactive EIA tests to HTLV-III antibody. Approximately one-third of these donors have other laboratory evidence of infection. Screening for HTLV-III is a new technology that illustrates virtually all of the factors that need consideration in an assessment of disease screening. This paper explores these technical, epidemiologic, economic, legal, social, and ethical factors.
疾病控制筛查可定义为一种预防性技术，用于检查无症状人群，以便将他们归类为可能或不太可能患有作为筛查对象的疾病。筛查可能包括常规体格检查、放射学检查、半侵入性检查（如内窥镜检查）或血清学检测。本文考虑一种新的血清学检测。获得性免疫缺陷综合征（艾滋病）是一种具有高死亡率的毁灭性疾病，最近发现它由一种名为人类T淋巴细胞嗜性病毒III型（HTLV-III）或淋巴结病相关病毒的逆转录病毒引起。当通过酶免疫测定（EIA）检查反应性血清标本的反应一致性时，其性能特征具有出色的高灵敏度和特异性。该检测现在是所有献血中心筛查方案的一部分，以降低通过血液或血液制品传播HTLV-III的风险。约0.2%（400人中1人）的献血者HTLV-III抗体酶免疫测定反复呈反应性。这些献血者中约三分之一有其他感染的实验室证据。HTLV-III筛查是一项新技术，几乎说明了疾病筛查评估中需要考虑的所有因素。本文探讨了这些技术、流行病学、经济、法律、社会和伦理因素。
