Babona D V, Slama G, Puiahi E
Department of Health, Port Moresby General Hospital, Boroko, Papua New Guinea.
P N G Med J. 1996 Sep;39(3):200-4.
In Papua New Guinea, the laboratory diagnosis of HIV infection is based on proof of HIV antibody in the patient's serum. Under the government scheme, the testing is done in 30 laboratories, including the Papua New Guinea HIV Reference Laboratory (NRL), the Red Cross Blood Transfusion Service in Port Moresby, and 19 provincial and 9 district laboratories. An alternative testing strategy was adopted in 1993 based on a WHO recommendation, replacing the classical testing strategy (enzyme immunoassay + Western blot). The alternative testing strategy uses several EIA, rapid or simple HIV antibody assays for the detection and confirmation of the HIV antibody. This approach is faster and cheaper, with the same sensitivity and specificity as the classical testing algorithm. Except for the NRL, the Serodia Fujirebio HIV-1 gelatin particle agglutination assay is used throughout the country as the screening test. The PNG National HIV Reference Laboratory is the only laboratory authorized to perform confirmatory testing and to release positive results. Therefore, all serum samples reactive in the screening assay are sent to the NRL for confirmation by the battery of EIA, rapid or simple assays in accordance with the alternative testing strategy adopted. The paper explains the alternative testing strategy and highlights the principle of each individual test that is employed.
在巴布亚新几内亚，艾滋病毒感染的实验室诊断基于患者血清中艾滋病毒抗体的检测结果。根据政府计划，检测工作在30个实验室进行，包括巴布亚新几内亚艾滋病毒参考实验室（NRL）、莫尔斯比港的红十字输血服务中心，以及19个省级实验室和9个地区实验室。1993年，根据世界卫生组织的建议采用了一种替代检测策略，取代了传统的检测策略（酶免疫测定法+蛋白质印迹法）。替代检测策略使用多种酶免疫测定法、快速或简易艾滋病毒抗体检测方法来检测和确认艾滋病毒抗体。这种方法更快、更便宜，与传统检测算法具有相同的灵敏度和特异性。除NRL外，全国都使用富士瑞必欧血清艾滋病病毒1型明胶颗粒凝集试验作为筛查检测方法。巴布亚新几内亚国家艾滋病毒参考实验室是唯一有权进行确认检测并公布阳性结果的实验室。因此，筛查检测中呈反应性的所有血清样本都将被送往NRL，按照采用的替代检测策略，通过一系列酶免疫测定法、快速或简易检测方法进行确认。本文解释了替代检测策略，并强调了所采用的每项检测的原理。
