Sensitivity and specificity of human immunodeficiency virus rapid serologic assays and testing algorithms in an antenatal clinic in abidjan, Ivory Coast

To evaluate serologic testing algorithms for human immunodeficiency virus ( HIV) based on a combination of rapid assays among persons with HIV-1 (non-B subtypes) infection, HIV-2 infection, and HIV-1-HIV-2 dual infections in A bidjan, Ivory Coast, a total of 1,216 sera with known HIV serologic status were used to evaluate the sensitivity and specificity of four rapid assays: Determine HIV-1/2, Capillus HIV-1/HIV-2, HIV-SPOT, and Genie II HIV-1/HIV- 2, Two serum panels obtained from patients recently infected with HIV-1 sub types B and non-B were also included. Based on sensitivity and specificity, three of the four rapid assays were evaluated prospectively in parallel (s erum samples tested by two simultaneous rapid assays) and serial (serum sam ples tested by two consecutive rapid assays) testing algorithms. All assays were 100% sensitive, and specificities ranged from 99.4 to 100%. In the pr ospective evaluation, both the parallel and serial algorithms were 100% sen sitive and specific. Our results suggest that rapid assays have high sensit ivity and specificity and, when used in parallel or serial testing algorith ms, yield results similar to those of enzyme linked immunosorbent assay-bas ed testing strategies. HIV serodiagnosis based on rapid assays may be a val uable alternative in implementing HIV prevention and surveillance programs in areas where sophisticated laboratories are difficult to establish.