Comparison of Western blot to rapid anti HIV testing: Usefulness in confirming true positivity

Shastry, S.; Katharia, R.; Dubey, A.; Elhence, P.; Chaudhary, R. K.
January 2008
Asian Journal of Transfusion Science;Jan-Jun2008, Vol. 2 Issue 1, p27
Academic Journal
Background: The National blood policy now requires that blood donors positive for HIV infection be informed of their result and referred to voluntary counseling and testing center (VGTC) for further work up. Since ELISA may be false reactive due to many reasons, confirmation of results may be required before informing the donors and referring them to VGTC for further work up. Till now Western blot is the Gold Standard as a confirmatory test but the cost is high. In recent years rapid anti HIV test kits with excellent sensitivity and specificity have been developed and anti HIV ELISA reactive samples are tested by three different rapid kits at VGTGs to give confirmatory diagnosis. Adm: To compare the performance characteristics of Western blot and rapid test assays as confirmatory test for HIV. Materials and Methods: Over a study period of 1 year (August 2006 to August 2007) out of 18192 blood donations, 57 donor samples were repeat ELISA reactive (0.0031%). Of these 17 were reactive by third generation Elisa and 40 by fourth generation ELISA These were further tested with Western blot ( J.Mitra & Co. Ltd) and three rapid test assays (HIV-Coomb: J.Mitra & Co. Ltd, HIV Bidot: Diagnos Ltd and HIV 1.2.0 Triline test: Transasia Biomedicals Ltd). Statistical tests were applied using SPSS version 13. P-value of <0.05 was considered significant. Results: Out of 57 repeatedly ELISA reactive samples, 16 (28%) were Western blot positive. The same samples turned out to be rapid test positive showing that correlation of Western blot with rapid test positivity is 100% and true HIV positivity in our donor population as 0.00088%. 7/17 (41.17%) of IIIrd generation ELISA reactive samples were true positive in comparison to 9/40 (22.5%) of fourth generation ELISA reactive samples. Cost analysis revealed that rapid test assays are more cost-effective compared to Western blot assays.


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