Reducing the Cost of HIV Antibody Testing

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

Reducing the Cost of HIV Antibody Testing

Lancet (Great Britain) (10/02/93) Vol. 342, No. 8875, P. 866 (Tamashiro, Hiko and Heymann, David)

Tamashiro and Heymann defend their suggestion that use of a second and third enzyme-linked immunosorbent assay (ELISA) or a simple-rapid test to confirm HIV infection is as sensitive and specific as western blot strategies. Their work was questioned by Simon and Brun-Vezinet, who were concerned that the proposed strategy was inadequate and debated whether the results of such tests should be disclosed to patients. The critics also suggested that seroconversion may be the cause of discrepant results of first and second tests, and that a p24 antigen test should be conducted in that case. The authors once again stress that the second and third tests should be similar to the first, thus reducing the probability of a false negative. While they agree that a p24 antigen test would be effective in determining results, Tamashiro and Heymann say that it may not be a viable option in resource-poor countries. They suggest a two-week wait and then another test from another blood sample to check for discrepant results. They also continue to support a serum-pooling strategy, which they believe is better that a strategy recommending individual testing in areas that lack supplies for HIV testing.

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