Heimer R, Jariwala B, Myers SS; International Conference on AIDS.
Int Conf AIDS. 1993 Jun 6-11; 9: 766 (abstract no. PO-C31-3297).
Dept. of Int. Medicine, Yale Univ., New Haven, CT.
OBJECTIVE: To evaluate the sensitivity and specificity of polymerase chain reaction (PCR) and antibody capture enzyme immunoassays (EIAs) in detecting HIV-1 specific products in used syringes. METHODS: PCR sensitivity was maximized; single copies of HIV-1 specific proviral DNA could be detected. In simulations, syringes loaded with 5 microliters of blood from HIV-1+ and HIV-1- individuals were extracted. Limits of detection were determined by diluting extracts and were correlated to CD4 cell counts. In addition, a random sample of 423 syringes from 171 NEP clients was tested. RESULTS: All techniques were highly specific: 100% for EIA and 95% for PCR. In simulations, the median volume of blood recovered from a used syringe required for a positive test was 0.045 microliter by PCR (equal to 13 CD4 cells), 0.04 microliter by the HIVAB HIV-1/2 rDNA based EIA, and between 0.001 and 0.00025 microliter by the HIVAB HIV-1 viral based EIA. Using PCR and the rDNA EIA, prevalences in syringes returned to the NEP were identical--42 positives in 144 samples (29.2%; 95% C.I. 21.7, 36.6%). Without pre-dilution the viral EIA detected 65 positives in 135 samples (48.1%; 95% C.I. 39.7, 56.6%). Analysis of NEP tracking data showed that 50% of the clients returned at least one syringe that was HIV-1+ by PCR or by viral EIA. CONCLUSIONS: The viral EIA without the recommended pre-dilution step was more sensitive than PCR or rDNA EIA. Overall, EIAs, with equal or higher sensitivity, greater specificity, and ease of preparation and analysis, are preferable to PCR for syringe testing in monitoring seroprevalence when direct testing of IVDUs is impractical.
Publication Types:
Keywords:
- CD4 Lymphocyte Count
- HIV-1
- Humans
- Immunoenzyme Techniques
- Needle-Exchange Programs
- Polymerase Chain Reaction
- Prevalence
- Seroepidemiologic Studies
- Syringes
- methods
Other ID:
UI: 102206592
From Meeting Abstracts