There was 100% agreement between enzyme immunoassay (EIA) (Abbott Laboratories), Western blot, and indirect immunofluorescence (IF) when these three methods were used to measure antibody to the acquired immune deficiency syndrome (AIDS) virus in sera from 142 high-risk individuals, indicating that IF was a sensitive alternative method for detecting antibody to this agent. Thirty-two (64%) of 50 EIA-positive plasma specimens from a blood bank and 6 (21%) of 28 EIA-positive sera from alternative testing sites were negative by IF. In addition, two EIA-negative sera from the latter group were positive by IF. Western blotting agreed with IF on those 40 specimens which gave discrepant results by EIA and IF. The IF method was determined to be equal to Western blotting in sensitivity and specificity for detection of AIDS antibody, and it was found to be useful for confirming positive EIA results, especially in specimens from individuals in low-risk groups.

Results by an enzyme immunoassay method (EIA) performed at one serum dilution and results by indirect immunofluorescence (IFA) and hemagglutination inhibition (HI) tests performed at step dilutions were correlated with results by a neutralization test (50% plaque neutralization [PN]) performed at step dilutions on single serum samples for serologic evaluation of immunity status to measles virus. PN results were taken as true indicators of immunity, and the other tests were evaluated on that basis. The predictive value of a positive result being positive also by PN was 95.3% for HI and 93.3% for EIA and IFA. The predictive value of a negative result being negative also by PN was 81.1% for HI, 100% for EIA, and 75.0% for IFA. A similar study on immunity status to varicella-zoster virus by EIA and by an anticomplement immunofluorescence test versus PN showed a 100% predictive value of a positive or negative result by EIA. By the anticomplement immunofluorescence test, the predictive value of a positive result was 97.7%, and that of a negative result was 88.5%. Studies on the comparative ability of EIA versus complement fixation (CF) to detect significant changes in antibody concentration between acute-phase and convalescent-phase serum samples indicative of a current infection were also done. Both tests were satisfactory for the serodiagnosis of measles or varicella-zoster virus infections. However, EIA was preferable to CF because it was less technically difficult, less labor intensive, and could be performed on sera that were anticomplementary in CF reactions.

A total of 3,349 serum samples were screened by the immunofluorescence (IF) method for antibody to human T-cell leukemia virus type I (HTLV-I). Only 9 of 2,409 specimens from selected individuals, blood bank donors, patients with encephalitis-meningitis, and human immunodeficiency virus antibody-positive homosexual or bisexual men were reactive by IF. In addition, 940 serum samples from intravenous drug abusers were tested by IF and also by an HTLV-I enzyme immunoassay (EIA) method. Of these, 222 (24%) were positive for both HTLV-I and HTLV-II antigens by IF, and 191 of these 222 were also reactive in the HTLV-I EIA. Of the 31 IF-positive, EIA-negative serum samples, 20 exhibited optical density readings greater than or equal to 70% of the positive cutoff in the EIA, and 29 samples reacted with 1 or more bands in the Western blot (immunoblot) test. An additional 10 specimens that were EIA negative reacted only with HTLV-I by IF. Differences in staining morphology and in reactions on HTLV-I and HTLV-II antigens before and after absorption of the serum specimens with HTLV-I and HTLV-II-infected cell pellets revealed six distinct serological patterns by IF. These results indicate that infections by HTLV-I or by another closely related retrovirus(es) occur in California. Further studies utilizing statistically valid sampling methods are needed to estimate true prevalence rates among various groups. IF and Western blot tests should supplement the EIA method to maximize sensitivity and specificity of test procedures.

We evaluated two commercial human T-cell lymphotropic virus (HTLV) Western blot (WB; immunoblot) kits, Cambridge Biotech Corp. (CBC) and Diagnostic Biotechnology Ltd. (DBL). Both methods employ HTLV type I (HTLV-I) viral lysate and rgp2l. The DBL WB kit also distinguishes between HTLV-I and HTLV-II antibodies, using an HTLV-I-specific and an HTLV-II-specific recombinant. Fifty weakly reactive HTLV-IIpositive plasma specimens which were falsely negative with the Abbott enzyme immunoassay (EIA) and 50 Ortho EIA false-positive samples were selected to determine sensitivity and specificity. The sensitivities of the CBC and the DBL WB kits were 90 and 68%, respectively. All positive samples reacted with rgp2l in both kits, but some did not display core bands. Five samples were typed as HTLV-I and four were typed as dual infection by the DBL WB kit. The specificities of the CBC and DBL kits were 48 and 70%o, respectively. The most prevalent WB reaction with the negative samples was with the core protein, p19, followed by p24 and p28 for CBC and rgp2l and p28 for DBL. DBL had two false-positive interpretations, and CBC had none. rgp2l was the most sensitive antigen in both kits for the weakly reactive HTLV-II samples. If all samples not reacting with this protein were interpreted as VB negative, regardless of other bands, the specificity would improve to 90% for CBC and 86% for DBL.