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M94A2704.TXT
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1994-10-25
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Document 2704
DOCN M94A2704
TI Western-blot--does it really help as a confirmatory test in a developing
country?
DT 9412
AU Buchalter M; Schneider EZ; Nottar VL; Barcellos NT; Ramos MC; Ferreira
JT; Balsan AM; Willers DM; Goncalves JE; Mondini LG; et al;
IPB--SSDT/AIDS--Rio Grande do sul State Health Secretariat, Porto;
Alegre, Brazil.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):243 (abstract no. PB0402). Unique
Identifier : AIDSLINE ICA10/94369871
AB OBJECTIVE: To evaluate the resolution of the Western-blot as a
confirmatory test in addition to the indirect immunofluorescence,
through a retrospective study of the laboratory records. METHODS: As a
routine, HIV-1 recombinant ELISA is used as a screening test. When
positive, the sample is tested with a competitive ELISA and Indirect
Immunofluorescence--IFI (Fundacao Osvaldo Cruz-Ministerio de Saude). In
case of negative or inconclusive IFI results, a Western-blot is
performed. If the Western-blot is negative or inconclusive a new sample
is collected after three months for retesting. Since 1990, approximately
20,000 HIV tests were performed at the Central State Public Health
Laboratory (Instituto de Pesquisas Biologicas). The samples come from
alternative anonymous test sites, STD clinics, blood banks, hospitals or
penitentiaries. RESULTS: 98% of the samples with a first ELISA positive
are confirmed through the subsequent tests, the remaining 2% present IFI
negative or indeterminate results. In a total of 73 samples with at
least one positive ELISA and a negative or inconclusive IFI were tested
with a Western-blot (Dupont, Sorin or Pasteur), using the CDCs criteria
for positivity. Out of these samples, only 23 (31.5%) were positive. Out
of the remaining 50 (68.5% of the total), 34 (68.0%) were inconclusive
and 16 (32.0%) were negative. CONCLUSION: Considering the high cost of
the Western-blot and the low index of resolution for the IFI negatives
or indeterminate cases--about 70% of them having to collect new
sample--we question the validity of including the Western-blot in the
diagnostic flowcharts for public health purposes.
DE *AIDS Serodiagnosis *Blotting, Western Brazil Comparative Study
*Developing Countries Fluorescent Antibody Technique Human HIV
Antibodies/BLOOD HIV Seropositivity/*DIAGNOSIS/IMMUNOLOGY
HIV-1/*IMMUNOLOGY Predictive Value of Tests Retrospective Studies
MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).