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COL James J. James, MC
USA

MAJ Michael A. Morgenstern, MC
USA Berlin

JAMA. 1985;254(11):1449.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The recent emphasis on the operating characteristics of the enzyme-linked immunosorbent assay (ELISA) human T-cell lymphotropic virus type III (HTLV-III) antibody test^1-3 and its role as a screening mechanism for the acquired immunodeficiency syndrome (AIDS) presents us with a crucial problem. We fail to see how the sensitivity and/or specificity of a screening test for an infectious disease can be precisely defined in the absence of either data on the true prevalence of infection within a population or a "gold-standard" confirmatory test to identify infection. To date, it seems that the operating characteristics of the HTLV-III ELISA antibody test have been defined (1) on the assumption that antibody seropositivity is a quantitative, predictive measure for viremia; (2) primarily among clinical populations; and (3) assuming, for the most part, the ELISA test itself as the most sensitive available. This is not to say that the HTLV-III antibody . . . [Full Text PDF of this Article]

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