Performance of commercial herpes simplex virus type-2 antibody tests using serum samples from Sub-Saharan Africa: a systematic review and meta-analysis.
Sex Transm Dis
; 38(2): 140-7, 2011 Feb.
Article
em En
| MEDLINE
| ID: mdl-20706175
ABSTRACT
BACKGROUND:
Several commercial type-specific serologic tests are available for herpes simplex virus type 2 (HSV-2). Poor specificity of some tests has been reported on samples from sub-Saharan Africa.METHODS:
To summarize the performance of the tests using samples from sub-Saharan Africa, we conducted a systematic review of publications reporting performance of commercially available HSV-2 tests against a gold standard (Western Blot or monoclonal antibody-blocking EIA). We used random-effects meta-analyses to summarize sensitivity and specificity of the 2 most commonly evaluated tests, Kalon gG2 enzyme-linked immunosorbent assay (ELISA), and Focus HerpeSelect HSV-2 ELISA.RESULTS:
We identified 10 eligible articles that included 21 studies of the performance of Focus, and 12 of Kalon. The primary analyses included studies using the manufacturers' cut-offs (index value = 1.1). Focus had high sensitivity (random effects summary estimate 99%, 95% confidence interval [CI] 99%-100%) but low specificity (69%, 95% CI 59%-80%). Kalon had sensitivity of 95% (95% CI 93%-97%) and specificity of 91% (95% CI 86%-95%). Specificity of Focus was significantly lower (P = 0.002) among HIV-positive (54%, 95% CI 40%-68%) than HIV-negative individuals (69%, 95% CI 56%-82%). When the cut-off optical density index was increased above the recommended value of 1.1 to between 2.2 and 3.5, the specificity of Focus increased to 85% (95% CI 77%-92%).CONCLUSIONS:
Sensitivity and specificity of HSV-2 tests used in sub-Saharan Africa vary by setting, and are lower than reported from studies in the United States and Europe. Increasing the cut-off optical density index may improve test performance. Evaluation of test performance in a given setting may help deciding which test is most appropriate.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Herpes Genital
/
Herpesvirus Humano 2
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Anticorpos Antivirais
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article