This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Novack, L. Articles by Sarov, B. Search for Related Content PubMed PubMed Citation Articles by Novack, L. Articles by Sarov, B.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, August 2006, p. 2909-2913, Vol. 44, No. 8
0095-1137/06/$08.00+0     doi:10.1128/JCM.02521-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Use of Seroconversion Panels To Estimate Delay in Detection of Anti-Human Immunodeficiency Virus Antibodies by Enzyme-Linked Immunosorbent Assay of Pooled Compared to Singleton Serum Samples

Department of Epidemiology, Ben-Gurion University of the Negev, Beer-Sheba, Israel,¹ Department of Statistics, Haifa University, Haifa, Israel,² Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland,³ Hepatitis Laboratory, Soroka University Medical Center, Beer-Sheva, Israel,⁴ Blood Services Center, Magen David Adom in Israel, Tel Hashomer, Israel⁵

Received 5 December 2005/ Returned for modification 6 February 2006/ Accepted 26 May 2006

The transfusion of unsafe blood worldwide accounts for 5 to 15% of new human immunodeficiency virus (HIV) infections, most of which occur in sub-Saharan Africa. While developed countries now apply PCR testing of pooled samples, some developing countries still do not have universal screening policies. More efficient low-cost procedures for the screening of pooled samples have the potential to encourage mass screening efforts in resource-poor settings. The aim of this study was to estimate the delay in the detection of HIV antibodies in pooled serum samples compared to that in singleton serum samples by enzyme-linked immunosorbent assay (ELISA) and to evaluate the risk of transfusion-transmitted HIV infection during the window period. Serial blood samples obtained from five HIV seroconversion panels were mixed with HIV-seronegative blood samples to create pools of 6, 12, 16, 24, 32, and 48 samples. The delay in detection of the first anti-HIV antibody-positive sample in tests with pooled samples was calculated for each pool size and compared to that obtained by testing of singleton samples and statistically evaluated by a robust log-linear regression analysis. The risk of a false-negative (FN) result caused by dilution was estimated by use of the incidence risk/window period model. The additional risk of transmission related to ELISA screening of pooled samples for HIV did not exceed 9% of the current risk of an FN result (estimated to be 1/1,067,000). The countries with virus prevalence rates in donors of less than 15% are expected to save up to 30% in the number of tests. ELISA screening of pooled samples could be considered in settings where the testing of blood supplies for HIV is not routinely done.