Simple/rapid test devices for anti-HIV screening: Do they come up to the mark?

Thirteen simple/rapid test devices (S/RTDs) for the detection of antibodies to HIV 1 and HIV 2 were assessed. Ninety-two specimens in four categories were used and results with the thirteen S/RTDs were compared with those obt ained with six currently available commercial laboratory-based anti-HIV 1/2 EIAs. Seven of the 13 S/RTDs scored all 26 blood donors' specimens as unre active, and 11 correctly identified all the 25 "straightforward" anti-HIV p ositive specimens. False negative results arose when testing by Uni-Gold HI V and SeroCard HIV, which gave 72 and 68 correct positive observations, res pectively, out of 75. No S/RTD detected seroconversion earlier than the mos t sensitive EIAs, but four S/RTDs performed similarly to most of the EIAs. On the low-titre panel specimens, six S/RTDs were less sensitive than the l east sensitive EIA and, in contrast to four of the six EIAs, only one S/RTD was able correctly to identify all the positive specimens. A manufacturing problem was identified that allowed the HIV antigen-sensitised area on the membrane of two SeroCard HIV devices to be misaligned with the device's re ading window so that the reaction was almost entirely obscured. As long as small numbers of specimens were involved, most S/RTDs required considerably less time and less equipment than EIAs, but overall they were slightly les s sensitive. Their use in various health settings and for confirmatory proc edures is discussed. Published 1999 Wiley-Liss, Inc.(dagger).