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John W. Ward, MD; Alfred J. Grindon, MD; Paul M. Feorino, PhD; Charles Schable, MS; Michael Parvin, MT; James R. Allen, MD, MPH

JAMA. 1986;256(3):357-361.

Abstract
The enzyme immunoassays (ElAs) for antibody to human T-cell lymphotropic virus type III (HTLV-III) were rapidly adopted for screening donated blood and plasma. To evaluate the significance of a positive EIA reaction, test performance was examined in a blood bank screening program. Specimens were tested by EIA, Western blot assay, and HTLV-III/ lymphadenopathyassociated virus (LAV) culture. The EIA was positive in 0.25% of 67 190 blood donations. Specimens were categorized and 57.3% had low (weak) reactivity, 12.7% had moderate reactivity, and 30.0% had high reactivity. Highly reactive specimens were strongly associated with a positive Western blot or culture (86.7%) in contrast to moderately and weakly reactive specimens (1.9%). Twenty-five of 29 donors interviewed with a highly reactive EIA had risk factors for HTLV-III/LAV infection. Risk factors were not identified for 74 of 75 interviewed donors with specimens of lower reactivity. The minimum calculated specificity was 99.82%. The use of the HTLV-III EIA has virtually eliminated the use of blood and plasma from HTLV-III/LAV infected donors.

(JAMA 1986;256:357-361)

Author Affiliations
From the AIDS Program, Center for Infectious Diseases, Centers for Disease Control (Drs Ward, Feorino, and Allen and Messrs Schable and Parvin), the American Red Cross Blood Services, Atlanta Region (Dr Grindon), and the Department of Pathology and Laboratory Medicine, Emory University (Dr Grindon), Atlanta.

Footnotes
Reprint requests to Blood and Transfusion Studies, AIDS Branch, Centers for Disease Control, Atlanta, GA 30333 (Dr Ward).

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