Serological diagnosis of HIV infection: practice and performance in western Europe

Article Abstract:

The human immunodeficiency virus (HIV) is the virus that causes AIDS. Early diagnosis of HIV infection is important so that the appropriate treatments can be started. Infection with HIV is routinely diagnosed by testing blood samples for the presence of antibodies against the virus, as tests for the virus itself often do not produce conclusive results. One of the most popular methods of diagnosing HIV uses a procedure called enzyme-linked immunosorbent assay (ELISA). Blood samples are placed in small plastic dishes that are coated with a specific protein that will interact only with antibodies against HIV that are present in the blood sample. Since a positive diagnosis of HIV infection has serious consequences for the individual, it is important to maintain high quality and standards of laboratory testing procedures. A questionnaire was used to evaluate the practices of western European and Scandinavian laboratories that perform routine testing for HIV. Sixty-seven laboratories participated in the study, and the majority of these laboratories used the ELISA to test for HIV. When an ELISA test was positive for HIV, most of the laboratories performed another type of test on the same sample to confirm the positive test result. Infection with HIV type 1 is a more common cause of AIDS than infection with HIV type 2, yet only 40 percent of the laboratories test for HIV type 2. The number of tests performed (the work load) varied from region to region, but the types of tests and strategies used were similar for the different regions. It is concluded that the standard of laboratory diagnosis of HIV is uniform across western Europe and that the quality of the testing is good. Consequently, data based on test results should be considered more or less reliable. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Statistics, Social policy, Western Europe, HIV seropositivity, HIV positive, Europe, Western, Diagnosis, Laboratory, Laboratory diagnosis

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Serological screening tests for syphilis in pregnancy: results of a five year study (1983-87) in the Oxford region

Article Abstract:

Treponema pallidum, the organism that causes syphilis, is capable of crossing the placental barriers and infecting the fetus. While many fetuses abort, many more survive and are infected with congenital syphilis. Inasmuch as congenital syphilis rarely occurs in the United Kingdom these days, the value of continued antenatal screening for this disease has been questioned. A modified retrospective study was conducted using the syphilis serology records obtained from the Oxford Regional Transfusion Center over the five-year period of 1983-1987. All antenatal serological tests from this region are referred to this agency for tests. A total of 76,519 pregnancies were recorded, with 62 positive tests. About two thirds of the 51 mothers had syphilis and the remainder were infected with non-venereal diseases such as yaws or pinta. Antenatal screening identified 13 previously unknown syphilis cases, and 11 were treated during their pregnancies. Six fetal losses were recorded, but none were due to congenital syphilis. None of the surviving children of this group showed evidence of congenital syphilis. Despite the continuing decline in the incidence of congenital syphilis in the United Kingdom, early detection and treatment is essential to prevent the occurrence of this disease and its aftermath. This clinical judgment supports the program of continued antenatal screening for syphilis. (Consumer Summary produced by Reliance Medical Information, Inc.)

United Kingdom, Prevention, Demographic aspects, Syphilis, Syphilis, Congenital, hereditary, and infantile, Congenital syphilis, Great Britain

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Serological diagnosis of neurobrucellosis

Article Abstract:

Brucellosis is a commonly occurring infectious disease in the regions around the Mediterranean. Neurobrucellosis is infection of the central nervous system by the bacteria involved that can occur at any time during the infection, with most cases diagnosed between 2 and 12 months after onset of symptoms. The reported incidence varies between 0.5 and 25 percent; the wide range is due to the lack of standardized diagnostic criteria. Specific diagnostic tests, such as the Rose Bengal test, the anti-Brucella Coombs' test, and microagglutination test (MAG) for the pathogen involved should be performed in each case. Six patients and 40 normal controls were used in the study. All six patients' cerebrospinal fluid (CSF) tested positive when the Coombs' test was used; five of the six patients had positive results when Rose Bengal and MAG tests were performed. In one case, the Coombs' test was the only positive indicator of infection. All 40 CSF controls were negative for all tests. It is recommended that serological tests be conducted on both CSF and serum specimens to assure valid diagnoses of neurobrucellosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Evaluation, Diagnosis, Neurologic manifestations of general diseases, Neurologic manifestations, Brucellosis, Diagnostic bacteriology

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