Evaluation of preliminary screening strategies for human immunodeficiency virus: a single center experience

Zhi-Qi Wu, Yan-Yan Liu, Fang Ni, Wei-Juan Song, Erfu Xie, Hemant Goyal, Hua-Guo Xu


Background: To compare and evaluate the available screening tests for human immunodeficiency virus (HIV) antibody screening test.
Methods: A retrospective analysis of 331,968 screening specimens for HIV antibody test from the First Affiliated Hospital of Nanjing Medical University between January 2010 and April 2014 was performed. Three hundred and thirty-two cases were screened positive with the third-generation enzyme-linked immunosorbent assay (3G ELISA) and colloidal gold-immunochromatography assay (GICA) and these samples were repeat-tested by the fourth-generation ELISA (4G ELISA). Repeat tested positive samples were again confirmed by western blot (WB) analysis. Comparative study was used to analyze the effectiveness of the 3G ELISA, 4G ELISA and/or combined with GICA, respectively for screening of presence of HIV antibody.
Results: Of the 332 positive 3G ELISA screening samples, 189 samples were confirmed to be positive for HIV by WB. The confirmed positive coincidence rate of 3G ELISA with WB was 57.27% and with 4G ELISA was 89.15%. The difference between the 3G and 4G ELISA in HIV antibody detection was statistically significant (P<0.01). When combined with GICA, the confirmed positive coincidence rate for 4G ELISA rose to 92.64% for detection of HIV antibody.
Conclusions: The 4G ELISA is a better HIV antibody screening test than 3G ELISA, especially when combined with GICA. The 4G ELISA combined with GICA appears to be a more suitable strategy for HIV antibody screening test in clinical practice.