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J Clin Virol. 2013 Dec;58 Suppl 1:e92-6. doi: 10.1016/j.jcv.2013.10.006.

The Multispot rapid HIV-1/HIV-2 differentiation assay is comparable with the Western blot and an immunofluorescence assay at confirming HIV infection in a prospective study in three regions of the United States.

Author information

1
San Francisco Department of Public Health, San Francisco, CA, United States. Electronic address: Mark_Pandori@sfdph.org.
2
New York City Department of Health & Mental Hygiene, New York City, NY, United States.
3
University of North Carolina at Chapel Hill, Chapel Hill, NC, United States(1).
4
Alameda County Department of Public Health, Oakland, CA, United States.
5
ICF International, Atlanta, GA, United States.
6
San Francisco Department of Public Health, San Francisco, CA, United States.
7
Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States.

Abstract

BACKGROUND:

A new HIV diagnostic algorithm has been proposed which replaces the use of the HIV-1 Western blot and HIV-1 immunofluorescence assays (IFA) as the supplemental test with an HIV-1/HIV-2 antibody differentiation assay.

OBJECTIVES:

To compare an FDA-approved HIV-1/HIV-2 antibody differentiation test (Multispot) as a confirmatory test with the HIV-1 Western blot and IFA.

STUDY DESIGN:

Participants were screened with an HIV-1/HIV-2 combination Antigen/Antibody (Ag/Ab) screening assay. Specimens with repeatedly reactive results were tested with Multispot and either Western blot or IFA. Specimens with discordant screening and confirmatory results were resolved with HIV-1 RNA testing.

RESULTS:

Individuals (37,876) were screened for HIV infection and 654 (1.7%) had a repeatedly reactive Ag/Ab assay result. On Multispot, 554 (84.7%) were HIV-1 reactive, 0 (0%) were HIV-2 reactive, 1 (0.2%) was reactive for both HIV-1 and HIV-2 (undifferentiated), 9 (1.4%) were HIV-1 indeterminate, and 90 (13.8%) were non-reactive. HIV-1 RNA was detected in 47/90 Multispot non-reactive (52.2%) specimens. Among specimens confirmed to have HIV infection (true positives), Multispot and Western blot detected HIV-1 antibody in a similar proportion of cases (93.7% vs. 94.4% respectively) while Multispot and IFA also detected HIV-1 antibody in a similar proportion of cases (84.5% vs. 83.4% respectively).

CONCLUSIONS:

In this study, Multispot confirmed HIV infections at a similar proportion to Western blot and IFA. Multispot, Western blot, and IFA, however, did not confirm all of the reactive Ag/Ab assay results and underscores the importance of HIV NAT testing to resolve discordant screening and confirmatory results.

KEYWORDS:

Algorithms; HIV; HIV serodiagnosis

PMID:
24342485
DOI:
10.1016/j.jcv.2013.10.006
[Indexed for MEDLINE]
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