Laboratory testing for infection with the human immunodeficiency virus: Established and novel approaches

The enzyme-linked immunosorbent assay (ELISA) and the Western blot are the primary tests for the diagnosis and confirmation of human immunodeficiency virus (HIV) infection. The ELISA, an inexpensive screening test for antibod ies to HIV-1, is both sensitive and specific. The HIV-1 Western blot is a r eliable confirmatory test following a repeatedly reactive ELISA. False-posi tive HIV-1 results with this sequence of tests are extremely rare but can o ccur, and test results that are inconsistent with clinical or other laborat ory information should be questioned, repeated, or supplemented. The US Foo d and Drug Administration has also approved rapid and more accessible testi ng methods. Oral mucosal transudate and urine testing are noninvasive testi ng methods; rapid and home sample collection kits offer easier access to te sting. Am J Med. 2000;109: 568-576. (C) 2000 by Excerpta Medica, Inc.