Pooling of sera for human immunodeficiency virus (HIV) testing: an economical method for use in developing countries

J Clin Pathol. 1988 May;41(5):582-5. doi: 10.1136/jcp.41.5.582.

Abstract

To determine whether donated blood samples in African countries could be pooled, then tested for the presence of human immunodeficiency virus (HIV) antibodies with a single test without loss of accuracy, a single test on five pooled samples was used, followed by individual testing of positive pools. This resulted in no loss of either sensitivity or specificity. Pooling 10 samples resulted in a loss of sensitivity for low antibody titre specimens. Pooling reduced the costs of screening by 70% and time needed for analysis. It is concluded that pooling of five samples for HIV screening may result in a substantial reduction in costs; in countries where the prevalence of HIV is higher than the 2-3% found in Zimbabwean donors, however, savings may not be as great.

PIP: The pooling of donated blood samples, followed by a single test for the presence of human immunodeficiency virus (HIV), has the potential of saving both time and money in developing countries; however, it is essential that such a procedure not compromise accuracy. To evaluate this possibility, a single test on 5 pooled samples from Zimbabwe was used, followed by individual testing of positive pools. This exercise was performed on 440 sera, or 88 pools of 5 and 44 pools of 10 sera. 17 positive results were identified through the individual testing of all sera. All 17 positive sera were also identified in the pools of 5, but 2 specimens were missed in the pools of 10 due to the loss of sensitivity for low antibody titer specimens. In addition to reducing the time needed for laboratory analysis, pooling reduces the costs of screening by 5% in settings where seroprevalence is 15% and by 70% when seroprevalence is 2%. In Zimbabwe, the cost of screening kits with this technique is 1/3 of what it would be if sera were tested individually. In general, the technique of pooling 5 sera seems cost-effective only when the prevalence of HIV seropositivity is 10% or less. The ability to declare specimens seronegative in lots of 5 also reduces the time that must be spent on record keeping as well as screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acquired Immunodeficiency Syndrome / immunology*
  • Acquired Immunodeficiency Syndrome / prevention & control
  • Antibodies, Viral / analysis*
  • Blood Donors
  • Blood Transfusion / economics
  • HIV / immunology*
  • HIV Antibodies
  • Humans
  • Mass Screening
  • Specimen Handling
  • Zimbabwe

Substances

  • Antibodies, Viral
  • HIV Antibodies