Avaliação do emprego de teste combinado antígeno/anticorpo na identificação de infecções recentes de HIV-I/II em doadores de sangue

Abstract

Blood transfusions is one of ways to infecte people with HI V vims. The use of tests in blood banksable to detect the infection during the period of immunological window, between the initial viremia and tile serumconvertion, has been a challenge to tíle scientific conununity. The occiurence of clinical signs ajad symptoms associated, to the disease^ and the behaviour of the donors are also evidences of the presence of the infection. Objective. The main purpose of the study was investigate the occurrence of recent infection of HI V through the use of antigen / antibody eornbmed test (HIV VÏDA& DUO) and epidetniological data from blood bank doiiors. Methodology. The study was developed in the Center ofHematology and Hemofherapy of Ceará from decembey2000 to decembec/2QQ3. A recettt trial that detected antigen p24 and IgG anti- HTV-1^2 in tíie human serum, was inserted in the senun routine and applied in 998 donors. Saiüples whose results were positive or mconelusive, whether m the conventional tests (Vironostika ïiïV 'ÜnÍ-form II plus OOrganon and ICE HTV-1.0.2;Murex), or m the study test (HIV VIDAS DUOBioMérieux), were subtnitted to Western Bht essays ÇHN Blot 2.2^1urex). The donors were then convoked to a new blood collection and new trials of ELISA were aGGomplished. The WestsmBlot tests vvere Garriêd out again to eonfinn the results. Results and discussion of the results. The population of blood donors was constifaited, in its majority, by male inaividual volunteers, with the age above -29 years old. The percentual niean of maptoiess clinic of donors and senuii inaptoess wererespectively, 21,3% and 8%. Ainongtlie most frequent factors as cause of clinical rejection were the sexxial practice without the iise of condom, the grippe state, hematocrite and hemoglobin levels under the acceptable values and prolonged fasting. Sensitivity, specificity, likelihood ratios, and the Kappa coefficients were calculated. Of the 998 blood donors, 937 had negative results for HIV in all three ELISA tests, and 61 (6,1%) had at least one positive or inconclusive result. Of these 61,11 were coüfinned to be positive by Western Blot There was no case of jserocomversijon. The sensibility of the combuied test was 100%. The specificities of the tests wew 99,0% (Vironostífca HIV Uni-fonn IT plus 0), 99,3% (VIDAS HTV DUO) and 99,7% (ICE HIV-1.0.2). The Kappa coefficient between the routine tests was 60,4%. The agreement between the combmed VIDAS fflV DUO test andthe ICE fflV-1.2.0 and Vironostika fflV Uni-form II plus O tests were Kappa=s68,3% and Kappa=54,t%; p<0,0001, respectively. Conclusion. This stady shows tíiat the performance of tile Gombined VIDAS HIV DUO test is similar to commercially available routine tests. Further studies are needed to confinn the usefulness of the combined test &>T deteGting recent HIV iïifectÍQn in sera of btooa áonQrs