Algorithm of HTLV-1/2 serological screening tests employed by Instituto Adolfo Lutz
Keywords:
Human T cell lymphotropic virus type 1 (HTLV-1), HTLV-2, serology, immuno enzimatic assay (EIA), Western Blot (WB), screening tests, antibodiesAbstract
The Ministry of Health of Brazil recommends for HTLV-1/2 diagnosis the use of one enzyme immunoassay (EIA) which contains selected antigens for HTLV-1 and HTLV- 2 in sera screening, and in reactive sera, re-testing in duplicate on the same EIA. This study had the objective to present the algorithm of screening tests used by Instituto Adolfo Lutz of São Paulo (IAL), that differs from the algorithm recommended by the Ministry of Health. Serum samples sent to IAL from Public Health clinics, and AIDS Reference Centers during December 1998 to March 2006 were analyzed for the presence of anti-HTLV-1/2 antibodies using two EIAs of different formats and composition. The results obtained are presented as st nd rd values of sensitivity, specificity and efficiency of EIA kits of 1 , 2 , and 3 generations in st nd rd relation to the confirmatory Western Blotting assay. Neither 1 and 2 , nor 3 generations EIA kits were able to detect all truly HTLV-1/2 positive sera. In spite of the best performance of nd 2 generation EIA kits, the results obtained emphasizes the need of using two EIAs as screening.The results obtained confirm and advise the use of two HTLV-1/2 EIAs as screening in Public Health Laboratories from Brazil, differently of the recommended by the Ministry of Health.
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Copyright (c) 2008 Fabrício Jacob, Elizabeth de los Santos-Fortuna, Adele Caterino-de-Araujo
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