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Performance Characteristics of Serologic Tests for Human Immunodeficiency Virus Type 1 (HIV-1) Antibody among Minnesota Blood Donors
Public Health and Clinical Implications
- Kristine L. MacDonald, MD;
- J. Brooks Jackson, MD;
- Robert J. Bowman, MD;
- Herbert F. Polesky, MD;
- Frank S. Rhame, MD;
- Henry H. Balfour, Jr, MD; and
- Michael T. Osterholm, PhD, MPH
Abstract
Study Objective: To evaluate performance characteristics of sequential enzyme immunoassay (EIA) and Western blot human immunodeficiency virus type 1 (HIV-1) antibody testing in a low-risk population.
Design: Three-year prospective study of a selected sample from a community-based population.
Setting: Two blood collection facilities in Minnesota.
Population: Minnesota blood donors.
Results: During the study period, 630 190 units of blood (donations) from an estimated 290 110 Minnesota-resident donors were screened for HIV-1 antibody. Seventeen Minnesota-resident donors were identified as positive for HIV-1 antibody. Sixteen donors were available for follow-up HIV-1 culture: all were culture positive. The other donor, who was not available for follow-up culture, was likely infected with HIV-1 based on a history of high-risk behavior and positive serologic findings for hepatitis B surface antigen. Using 95% binomial confidence intervals, performance characteristics for sequential EIA and Western blot HIV-1 antibody serology were as follows: false-positive rate by number of donations, 0% to 0. 0006%; specificity by number of donations, 99.9994% to 100%; predictive value of a positive test, 81% to 100%.
Conclusions: In this low-risk population, the false-positive rate of serologic tests for HIV-1 antibody, using HIV-1 culture as the definitive standard for infection status, was extremely low and test specificity was extremely high.
Article and Author Information
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From the Minnesota Department of Health, the University of Minnesota Medical School, and the Memorial Blood Center of Minneapolis, Minneapolis, Minnesota; American Red Cross Blood Services, St. Paul, Minnesota. For current author addresses, see end of text.
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Grant Support: Partial support by grant AI-27661 from the National Institute of Allergy and Infectious Disease.
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Requests for Reprints: Kristine L. MacDonald, MD, Minnesota Department of Health, 717 Delaware Street Southeast, Minneapolis, MN 55440.
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Current Author Addresses: Drs. MacDonald and Osterholm: Acute Disease Epidemiology Section, Minnesota Department of Health, Minneapolis, MN 55440.
Dr. Jackson: Department of Laboratory Medicine, University of Minnesota Medical School, Minneapolis, MN 55455 and the American Red Cross Blood Services, St. Paul Region, St. Paul, MN 55107.
Dr. Bowman: American Red Cross Blood Services, St. Paul Region, St. Paul, MN 55107.
Dr. Polesky: The Memorial Blood Center of Minneapolis, Minneapolis, MN 55404.
Drs. Rhame and Balfour: Department of Internal Medicine, and Departments of Laboratory Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455.
- ©1989 American College of Physicians
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