PubMed · 11653777
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Barbara Kantrowitz, Mary Hager, Lisa Drew. 1987-06-15. The problem with testing.. https://pubmed.ncbi.nlm.nih.gov/11653777/
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Less sensitive (LS) HIV-1 enzyme immunoassays (EIAs) have significantly improved the quantity and quality of HIV surveillance data. The first LS-HIV-1 EIA, the Abbott 3A11-LS, provided reliable incidence data, but the assay required specialized equipment, and the lack of available reagents made testing difficult. This study evaluated the use of an alternate assay, a modified version of the Vironostika HIV-1 EIA (Vironostika-LS), to be used for LS testing. The Vironostika-LS has similar performance characteristics to the Abbott 3A11-LS with additional advantages. This 96-well formatted assay is commonly found in public health laboratories for routine HIV-1 testing and can be used with both serum and dried blood spot specimens. The estimated mean time from seroconversion (defined using a standardized optical density cutoff of 1.0) with the Vironostika-LS was 170 days (95% CI, 145-200 days). When the Vironostika-LS was applied to a matched serum set previously tested with the Abbott 3A11-LS, the Vironostika-LS accurately identified 97% of specimens with recent or long-standing HIV infection. The paper also reports Vironostika-LS quality control guidelines and the results from 3 rounds of proficiency testing.
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Injection-drug use is a risk factor for acquired immunodeficiency syndrome (AIDS). Of the 765,559 cumulative AIDS cases diagnosed as of December 2000, a total of 193,527 (25%) occurred among injection-drug users (IDUs). IDUs become infected with human immunodeficiency virus (HIV) through sharing injection-drug equipment with HIV-infected persons or by engaging in other risk behaviors such as having unprotected sex. Since 1995, AIDS incidence among IDUs has declined. This report presents data on initial HIV diagnoses among IDUs aged >/=13 years, with and without AIDS at the time of HIV diagnosis, by year, during 1994--2000. The findings indicate that HIV diagnoses among IDUs have leveled in the majority of demographic groups during this period in the 25 states for which HIV surveillance data are available. Because IDUs and their sex partners represent approximately one third of persons infected in the HIV epidemic and continue to be at risk for transmitting HIV, prevention efforts targeting IDUs and their sex partners should be enhanced.