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Comparative evaluation of three FDA-approved HIV Ag/Ab combination tests using a genetically diverse HIV panel and diagnostic specimens.

Comparative evaluation of three FDA-approved HIV Ag/Ab combination tests using a genetically diverse HIV panel and diagnostic specimens.
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Qiu X, Sokoll L, Yip P, Elliott DJ, Dua R, Mohr P, Wang XY, Spencer M, Swanson P, Dawson GJ, Hackett J,


Qiu X, Sokoll L, Yip P, Elliott DJ, Dua R, Mohr P, Wang XY, Spencer M, Swanson P, Dawson GJ, Hackett J, (click to view)

Qiu X, Sokoll L, Yip P, Elliott DJ, Dua R, Mohr P, Wang XY, Spencer M, Swanson P, Dawson GJ, Hackett J,

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Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology 2017 05 1392() 62-68 pii 10.1016/j.jcv.2017.05.005

Abstract
BACKGROUND
HIV Ag/Ab combination assays are recommended by CDC for routine screening and several HIV Ag/Ab combination tests are now FDA-approved. Maintaining high specificity and consistent sensitivity across diverse HIV strains is critical for these assays to accurately detect HIV infection and expedite delivery of patient results.

OBJECTIVES
To evaluate performance of three FDA-approved HIV tests: ARCHITECT HIV Combo (Abbott), ADVIA Centaur HIV Combo (Siemens) and BioPlex HIV Ag-Ab (Bio-Rad).

STUDY DESIGN
Sensitivity and specificity were evaluated using an extensive panel of 28 HIV infected human specimens and 17 cultured virus isolates representing multiple genotypes, 6 seroconversion panels, 4 human samples with acute infection, WHO p24 standard and 4020 clinical specimens.

RESULTS
The p24 limit of detection (LOD) for the WHO standard was 0.19IU/ml, 0.70IU/ml, and 1.77IU/ml in BioPlex, ARCHITECT, and Centaur respectively. The distribution of LODs across 15 HIV-1 isolates was substantially narrower in ARCHITECT (5-33pg/ml) than in BioPlex (11-198pg/ml) and Centaur (6-384pg/ml). All assays detected antibodies to the majority of HIV-1 and HIV-2 variants. However, reduced sensitivity was observed for Centaur in detection of antibodies to HIV-1 group M (CRF02_AG), O and N variants. BioPlex and ARCHITECT showed better seroconversion sensitivity than Centaur, detecting one bleed (3-7 days) earlier in 4 (BioPlex) and 3 (ARCHITECT) of 6 seroconversion panels. ARCHITECT demonstrated the highest specificity (99.90-100%) compared to BioPlex (99.80%) and Centaur (99.42%).

CONCLUSIONS
The overall performance of ARCHITECT and BioPlex was superior to Centaur, especially for detection of acute HIV infection.

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