Whole-blood samples were used for a counting immunoassay (CIA) with the aim of developing a short-turnaround test. After optimization of the CIA, hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibodies (anti-HCV), and anti-Treponema pallidum antibodies (anti-TP) were detected as efficiently as by an enzyme immunoassay (EIA) with serum samples. The correlations between whole-blood CIA and serum EIA were 99.8, 97.1, and 99.4% for HBsAg, anti-HCV, and anti-TP, respectively. Whole-blood CIA may be of value when rapid screening of many samples is required.The counting immunoassay (CIA) is an application of particle counting technology to serological tests (6). Latex particles are agglutinated by antibodies or antigens of interest and are quantified by scattered laser light while passing through a controlled sheath flow, which is also used in flow cytometry. A similar method is the particle counting immunoassay, in which nonagglutinated particles are counted with the aid of instrumentation (1,4,5). Reported applications of these methods, most of which use serum samples, include the detection of hepatitis B virus (HBV) antigens or antibodies (1), anti-adult T-cell leukemia antibodies (6), antitoxoplasma antibodies (2), urinary cotinine (3), hormones (4), and serum acute-phase proteins.The advantages of CIA in comparison with traditional enzymatic methods include a reaction time as short as 15 min, high throughput, and small sample volumes. Taking these advantages into account, we evaluated whole-blood assays by using CIA to develop a short-turnaround test. In general, the preferred sample for a short-turnaround test is whole blood because the preparation of serum samples, including centrifugation time, inevitably takes 30 to 40 min after the blood has been drawn. Since currently available CIA reagents are designed for serum samples, we decided to optimize CIA reagents for whole blood.Whole-blood samples were tested for hepatitis B, hepatitis C, and syphilis, with the reagents, detector, and internal software all optimized. The results were compared with those obtained by an enzyme immunoassay (EIA) with paired serum samples.
MATERIALS AND METHODSPrinciples of detection by CIA. The principles of the CIA have been described elsewhere in detail (6). In brief, latex particles 0.75 m in diameter (standard deviation, 0.015 m) are coated with antigens or antibodies that interact with the substance of interest. Next, the particles are mixed with a whole-blood or serum sample in an automated detector. Fifteen minutes later, when the particles are agglutinated by an antigen-antibody reaction, they are sent to a flow cell mechanism for passage in a single line. Their sizes and frequencies are measured by scattered laser light while they pass through the flow cell, and the numbers of agglutinated multimeric and nonagglutinated monomeric particles are counted (Fig. 1). When a whole-blood sample is used, the number of agglutinated multimeric particles is automatically compensated for by the number of red blood cells (...