ACCURATE DETECTION OF MATERNAL ANTIBODIES TO HIV IN NEWBORN WHOLE-BLOOD DRIED ON FILTER-PAPER
ACCURATE DETECTION OF MATERNAL ANTIBODIES TO HIV IN NEWBORN WHOLE-BLOOD DRIED ON FILTER-PAPER
复制标题
DOI：
10.1097/00002030-199304000-00005
复制
发表时间：
1993-04-01
期刊：
影响因子：
3.8
通讯作者：
RYDER, RW
中科院分区：
文献类型：
--
作者：
PAPPAIOANOU, M;KASHAMUKA, M;RYDER, RW
目的：1987年首次描述了使用酶免疫测定法（EIA）对滤纸上干燥的新生儿血液样本进行母体HIV抗体检测，并通过免疫印迹法（IB）确认重复反应样本。它已被用于在几个国家进行大规模、无关联、匿名的艾滋病毒血清阳性率调查，以监测育龄妇女的艾滋病毒感染情况。我们直接评估了检测母体HIV抗体的这种组合的敏感性和特异性。设置：从在扎伊尔金沙萨的一家大医院分娩的母亲中获得的血清样品使用快速测定HIVCHEK筛选HIV抗体。设计：来自HIVCHEK阳性妇女和年龄匹配的阴性对照的血浆通过酶联免疫吸附测定（ELISA）进行测试;重复反应的标本通过Western blot（WB）确认。分娩后两天，通过足跟贴从每个新生儿获得全血，在滤纸上干燥，并通过EIA测试。IB确认了重复反应性标本。主要结局指标。结果：EIA法检测新生儿滤纸片标本，IB法对反复反应标本进行确证试验，其敏感性为100.0%，在192份ELISA阳性、WB阳性的母血浆标本中，192份对应的新生儿滤纸片标本EIA阳性、IB阳性;置信区间（CI），98.1-100]。使用该组合检测，母体HIV抗体的检测特异性为99.60/o（在281份ELISA阴性或ELISA阳性但WB阴性的母体血浆样本中，280份相应的新生儿滤纸样本为EIA阴性或EIA阳性但IB阴性; 950/o CI，98.0-100）。通过检测滤纸上干燥的新生儿血液，使用EIA并通过IB确认重复反应的标本，可以准确检测母体HIV抗体。这种方法可以促进在有新生儿筛查计划的国家或难以获得血清或血浆的国家确定育龄妇女的艾滋病毒血清阳性率。
Objective: The testing of neonatal blood specimens dried on filter paper for maternal HIV antibodies, using an enzyme immunoassay (EIA) with confirmation of repeatedly reactive specimens by immunoblot (IB), was first described in 1987. It has been used to conduct large, unlinked, anonymous HIV seroprevalence surveys for surveillance of HIV in child-bearing women in several countries. We directly assessed the sensitivity and specificity of this combination of tests to detect maternal HIV antibodies.Setting: Serum samples obtained from mothers delivering at a major hospital in Kinshasa, Zaire were screened for HIV antibody using the rapid assay HIVCHEK.Design: Plasma from HIVCHEK-positive women and age-matched negative controls were tested by enzyme-linked immunosorbent assay (ELISA); repeatedly reactive specimens were confirmed by Western blot (WB). Two days after delivery, whole blood was obtained from each newborn by heel-stick, dried on filter paper, and tested by EIA. Repeatedly reactive specimens were confirmed by IB.Main outcome measure. The serologic status of neonatal filter-paper specimens was compared with that of corresponding maternal plasma.Results: The testing of neonatal filter-paper specimens using EIA, with confirmatory testing of repeatedly reactive specimens using IB, was 100.0% sensitive [of the 192 ELISA-positive and WB-positive maternal plasma specimens, 192 of the corresponding newborn filter-paper specimens were EIA-positive and IB-positive; 950/o confidence interval (CI), 98.1-100]. The detection of maternal HIV antibodies was 99.60/o specific using this combination of tests (of the 281 ELISA-negative or ELISA-positive but WB-negative maternal plasma samples, 280 of the corresponding newborn filter-paper specimens were EIA-negative or EIA-positive but IB-negative; 950/o CI, 98.0-100).Conclusions: Maternal HIV antibodies can be detected accurately by testing neonatal blood dried on filter paper, using EIA with confirmation of repeatedly reactive specimens by IB. This approach can facilitate the determination of HIV seroprevalence in child-bearing women in countries with neonatal screening programs, or where serum or plasma is difficult to obtain.