Nunn A J, Biryahwaho B, Downing R G, van der Groen G, Ojwiya A, Mulder D W
Medical Research Council Programme on AIDS in Uganda, Uganda Virus Research Institute, Entebbe.
AIDS. 1993 Aug;7(8):1057-61. doi: 10.1097/00002030-199308000-00005.
To evaluate an algorithm using two enzyme immunoassays (EIA) for anti-HIV-1 antibodies in a rural African population and to assess alternative simplified algorithms.
Sera obtained from 7895 individuals in a rural population survey were tested using an algorithm based on two different EIA systems: Recombigen HIV-1 EIA and Wellcozyme HIV-1 Recombinant. Alternative algorithms were assessed using negative or confirmed positive sera.
None of the 227 sera classified as unequivocably negative by the two assays were positive by Western blot. Of 192 sera unequivocably positive by both assays, four were seronegative by Western blot. The possibility of technical error cannot be ruled out in three of these. One of the alternative algorithms assessed classified all borderline or discordant assay results as negative had a specificity of 100% and a sensitivity of 98.4%. The cost of this algorithm is one-third that of the conventional algorithm.
Our evaluation suggests that high specificity and sensitivity can be obtained without using Western blot and at a considerable reduction in cost.
评估一种使用两种酶免疫测定法（EIA）检测非洲农村人群抗HIV-1抗体的算法，并评估替代的简化算法。
在一项农村人口调查中，从7895名个体采集的血清使用基于两种不同EIA系统的算法进行检测：重组HIV-1 EIA和Wellcozyme HIV-1重组检测。使用阴性或确诊阳性血清评估替代算法。
两种检测均明确分类为阴性的227份血清，经蛋白免疫印迹法检测均为阴性。两种检测均明确为阳性的192份血清中，有4份经蛋白免疫印迹法检测为血清阴性。其中3份不能排除技术误差的可能性。评估的一种替代算法将所有临界或不一致的检测结果分类为阴性，其特异性为100%，敏感性为98.4%。该算法的成本是传统算法的三分之一。
我们的评估表明，不使用蛋白免疫印迹法也能获得高特异性和敏感性，且成本大幅降低。
