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Journal of Clinical Microbiology, January 1998, p. 123-127, Vol. 36, No. 1
Projet RETRO-CI, CHU Treichville, Abidjan,
Ivory Coast,1 and
Division of HIV/AIDS
Prevention, National Center for HIV, STD, and TB Prevention,
Centers for Disease Control and Prevention, Atlanta,
Georgia2
Received 15 July 1997/Returned for modification 24 September
1997/Accepted 24 October 1997
Serologic distinction between human immunodeficiency virus type 1 (HIV-1) and HIV-2 infection is made difficult because of the
cross-reactivity and high cost of existing differentiation assays. An
evaluation of a strategy based on a combination of monospecific
enzyme-linked immunosorbent assays (ELISAs) (CME), was carried out in
Abidjan, Ivory Coast, where both HIV-1 and HIV-2 are present, to
determine its accuracy and cost-effectiveness. A total of 1,608 (428 HIV-1-positive, 361 HIV-2-positive, 371 dually HIV-1 and HIV-2
[HIV-D] reactive, and 448 HIV-negative) sera that had been serotyped
by a line immunoassay (Peptilav) were tested retrospectively by an
HIV-1-monospecific (Wellcozyme HIV Recombinant ELISA) and an
HIV-2-monospecific (ICE*-HIV-2) assay. The CME strategy gave concordant
results for all of the 428 sera scored as HIV-1 by Peptilav. Of the 361 sera scored as HIV-2 by Peptilav, 316 (87.5%) were scored as HIV-2 by
CME; the remaining 45 sera were positive by both monospecific ELISAs
(mean optical density ratios, 1.36 for Wellcozyme and 11.30 for
ICE*-HIV-2) and were classified as HIV-D by CME. Of the 371 sera
classified as HIV-D by Peptilav, 344 (92.7%), 21, and 6 were scored as
HIV-D, HIV-1, and HIV-2, respectively, by CME. Additional testing of the discrepant samples by two HIV differentiation assays (RIBA and
INNO-LIA) gave results that agreed with those by CME for most of the
sera. In addition, 267 other sera were tested prospectively by both CME
and Peptilav. In the prospective evaluation, CME results agreed with
those by Peptilav for all 106 HIV-1 sera and 40 of the 41 HIV-2 sera.
However, of the 120 sera scored as HIV-D by Peptilav, 69 (57.5%), 47 (39.2%), and 4 (3.3%) were scored as HIV-D, HIV-1 only, and HIV-2
only, respectively, by CME. All 47 samples scored as HIV-1 by CME and
two of four HIV-2 sera gave concordant results by RIBA, whereas 29 of
47 sera scored as HIV-1 by CME and all four HIV-2 sera gave concordant
results by INNO-LIA. The reagent cost for the CME strategy was 59%
lower than the cost of the Peptilav strategy. These results suggest
that a combination of highly sensitive and specific commercially
available monospecific ELISAs is a reliable and cost-effective strategy
for type-specific serodiagnosis of HIV-1 and HIV-2 infections in
HIV-seropositive persons and therefore represents a recommended
strategy in areas where both HIV-1 and HIV-2 are endemic.
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Field Evaluation of a Combination of Monospecific Enzyme-Linked
Immunosorbent Assays for Type-Specific Diagnosis of Human
Immunodeficiency Virus Type 1 (HIV-1) and HIV-2 Infections in
HIV-Seropositive Persons in Abidjan, Ivory Coast
*
Corresponding author. Mailing address: Projet RETRO-CI,
Virology Laboratory, BP 1712, 01 Abidjan, Ivory Coast. Phone: (225) 25 41 89. Fax: (225) 24 29 69. E-mail: jcn5{at}cdc.gov.
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