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Serodiagnosis of the Acquired Immune Deficiency Syndrome by Enzyme-Linked Immunosorbent Assay Compared to Cellular Immunologic Parameters in African Aids Patients and Controls

Henry L. Francis^*,,, Jonathan Mann^,,, Robert L. Colebunders^,,, Lubaki Ndongala, Duma Mavunza-Mpaka, Kapita Bila^¶, James Curran, Peter Piot AND Thomas C. Quinn^*

^* Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
Project SIDA, Department of Public Health, Kinshasa, Zaire
AIDS Program, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
Institute of Tropical Medicine, Antwerp, Belgium
^¶ Department of Internal Medicine, Mama Yemo Hospital, Kinshasa, Zaire

The sensitivity and specificity of an enzyme-linked immunosorbent assay (ELISA), absolute numbers of T-helper cells, and T-helper: T-suppressor cell ratios were compared in asymptomatic controls and IgG Western blot-confirmed patients with the acquired immune deficiency syndrome (AIDS) in Kinshasa, Zaire, between August 1984 and May 1985. Two hundred sixteen (97.7%) of 221 IgG western blot-positive AIDS patients and 4 of 97 (4%) controls were ELISA-positive, 3 of whom were Western blot-positive. The sensitivity and specificity of the ELISA was 97.7% and 99.0%, respectively, compared to Western blot results. Detection of the human immune deficiency virus using absolute number of T-helper cells (<400 cells/mm³) was as sensitive (98.2%), but less specific (90.7%). A T-helper: T-suppressor ratio of <0.9, had a sensitivity of 97.3%, and specificity of 94.8%. The ELISA test had the highest predictive value and greatest utility in an African clinical setting for detecting HIV infected patients were a wide range of other immunocompromising diseases are seen.

Accepted for publication September 8, 1987.