Evaluation of a new screening assay kit for the combined detection of HIV p24 antigen and antibody--comparison of the performance of the new kit and HIV antibody assay kits

Abstract

DUO is an automated HIV infection screening test kit based on the combined detection of p24 Ag and anti-HIV-1 and anti-HIV-2 IgG in human sera or plasma using the ELFA technique (Enzyme-Linked Fluorescent Assay). The performance of DUO was compared with that of HIV-1/HIV-2 3rd generation EIA plus and particle agglutination (PA) test. A total of 141 seropositive sera, 3 seroconversion panels, 300 seronegative sera and 387 potentially cross-reactive serum samples were tested. One hundred and forty one seropositive sera in Japan and Cameroon were all positive with DUO. Three seroconversion panels (panel Q, Z, AE) were tested to evaluate sensitivity. In Panel Q, infecution was detected seven days earlier with DUO than with the 3rd generation EIA plus and PA. In Panel AE, infection was detected four days earlier with DUO than with the single antibody assays. Three hundred seronegative sera from Kanagawa prefectural public health centers were all negative with DUO as well as PA test. Three hundred and eighty seven potentially cross-reacting samples were tested to challenge the specificity of the assay. These included samples from pregnant women and hepatitis patients. In four of the 204 samples from pregnant women, false-positive results were observed with DUO. In three of the 183 samples from hepatitis patients, false-positive results were also obtained with DUO. All samples of 7 DUO positive results were negative with western blot test. Five of them were negative with RT-PCR and 2 of them were not tested because there were not enough samples. Thirty cross-reacting (false-positive) samples by PA test from blood donors were tested by DUO, and all of these were negative by DUO.