Comparative performance of peptide-, recombinant protein-, and viral lysate-based enzyme immunosorbent assays for the detection of HIV-1 antibodies.

The performance of peptide-, recombinant protein-, and whole virus lysate-based enzyme immunosorbent assays (EIAs) for the detection of antibodies to the human immunodeficiency virus type 1 (HIV-1) was compared on a panel of 245 routine samples, a panel of low-positive samples, four seroconversion panels, and serial dilutions of five known positive samples. Of the 245 routine samples, 83 were confirmed to be HIV-1 antibody positive by Western blot and were reactive in the three EIAs used. Agreement between the three EIA tests was also 100% for all 162 negative samples. Although there was no significant difference in the performance of the three types of assays in seroconversion panels, the whole virus and recombinant protein-based EIAs detected 15 of 15 samples in the low-positive panel whereas only 10 of 15 samples were reactive when the peptide-based EIA was used. In addition, evaluation of diluted positive samples suggested that the virus lysate-based EIA was more sensitive than the peptide- and recombinant-based EIAs. These results show that although the three types of assays performed well on routine serum panels, differences in sensitivities were demonstrated when performance panels were evaluated. The data suggest that seroconversion and low-positive performance panels should be included in evaluations of new generations of EIAs for HIV-1 antibodies.