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De Paschale M, Manco MT, Cianflone A, Belvisi L, Cagnin D, Cerulli T, Paganini A, Agrappi C, Mirri P, Clerici P. Evaluation of the vitros hiv combo 4th generation test for the identification of HIV infections. J Clin Virol 2018; 108:77-82. [PMID: 30266004 DOI: 10.1016/j.jcv.2018.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/11/2018] [Accepted: 09/14/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Simultaneous detection of HIV 1 and 2 antibodies and HIV-1 p-24 antigen in the 4th generation tests is particularly effective for the identification of early acute HIV infections while maintaining accurate detection of long-established infections. OBJECTIVES The aim of this study was to evaluate the new 4th generation VITROS HIV Combo test from Ortho-Clinical Diagnostics by comparing its results with those obtained using a 3rd generation HIV 1/2 antibody test (VITROS Anti HIV 1 + 2 from Ortho-Clinical Diagnostics) and a 4th generation test (LIAISON XL HIV Ab/Ag, DiaSorin) currently used in the Microbiology Unit of Legnano Hospital. STUDY DESIGN One thousand and three samples of the normal daily routine (Group 1) were analyzed simultaneously with the three systems. The concordant and discordant sample results were further tested using Western blot and HIV-RNA assay (Roche). One hundred samples (Group 2) of known HIV positive subjects (63 of subtype B, 37 subtype non-B, and 51 with positive viraemia) and 50 samples (Group 3) with indeterminate Western blot were also examined using the three systems. From Group 3, 24 samples were collected from patients diagnosed with acute infection. RESULTS The overall agreement between the three systems was 99.4% (99.5% in group 1, 100% in group 2 and 96.6% in group 3) with a coefficient Fleiss Kappa of 0.9814. Notably, the VITROS HIV Combo test was positive in all known HIV positive samples of group 2 without any statistically significant difference in the values of the sample/cut off ratios between the B and non-B subtypes and between the positive and negative viraemia samples in established infections. The VITROS HIV Combo test was also positive in all samples of patients with acute infection in group 3. CONCLUSIONS The VITROS HIV Combo test has shown comparable performance to the other two assays in use of 3rd and 4th generation tests and is able to correctly identify both acute and established HIV infections independently of viraemia and HIV subtype.
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Affiliation(s)
- Massimo De Paschale
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy.
| | - Maria Teresa Manco
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
| | - Annalisa Cianflone
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
| | - Luisa Belvisi
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
| | - Debora Cagnin
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
| | - Teresa Cerulli
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
| | - Alessia Paganini
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
| | - Carlo Agrappi
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
| | - Paola Mirri
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
| | - Pierangelo Clerici
- Microbiology Unit, Hospital of Legnano, ASST Ovest Milanese, Legnano (Mi), Italy
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De Paschale M, Manco MT, Arpino O, Ricucci V, Paganini A, Belvisi L, Cagnin D, Cerulli T, Cianflone A, Agrappi C, Mirri P, Clerici P. Threshold value of LIAISON XL anti-HCV screening assay predicting positive immunoblotting results. J Med Virol 2017; 89:1817-1822. [PMID: 28401710 DOI: 10.1002/jmv.24831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 04/01/2017] [Indexed: 11/06/2022]
Abstract
Some international guidelines recommend evaluating the need to confirm positive anti-hepatitis C virus (HCV) antibody screening results by means of a more specific antibody or molecular biology test on the basis of a screening threshold value (such as the sample signal/cut-off ratio) that can predict the positivity of additional antibody testing in at least 95% of cases. The aim of this study was to determine the threshold value of the DiaSorin LIAISON XL chemiluminescence test. Two hundred and twenty-eight routine laboratory samples that were chemiluminescence positive for anti-HCV antibodies but had different signal/cut-off ratios were assayed using immunoblotting, which indicated that 155 (68.0%) were positive, 40 (17.5%) were negative, and 33 (14.5%) were indeterminate. When the samples were divided on the basis of their signal/cut-off ratios, 95.5% of the samples with a ratio of ≥3.5 were positive as against 74.1% of the positive or indeterminate samples with a ratio of <3.5. Statistical analysis using Youden's index and a receiver operating characteristic curve showed that the optimum cut-off value was 3.65. These findings indicate that, when using the LIAISON XL system for anti-HCV antibody screening, a signal/cut-off ratio of ≥3.65 makes further confirmatory tests unnecessary.
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Affiliation(s)
- Massimo De Paschale
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Maria Teresa Manco
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Olivia Arpino
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Valentina Ricucci
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Alessia Paganini
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Luisa Belvisi
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Debora Cagnin
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Teresa Cerulli
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Annalisa Cianflone
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Carlo Agrappi
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Paola Mirri
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
| | - Pierangelo Clerici
- Microbiology Unit, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy
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