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Herpes Simplex Virus-Type 2 Antibody Detection Performance in Kisumu, Kenya, using the HerpeSelect ELISA, Kalon ELISA, Western Blot and Inhibition Testing
  1. J. S. Smith (jennifers{at}unc.edu)
  1. University of North Carolina at Chapel Hill, United States
    1. R. C. Bailey
    1. University of Illinois at Chicago, United States
      1. D. J Westreich
      1. University of North Carolina at Chapel Hill, United States
        1. I. Maclean
        1. University of Manitoba, Canada
          1. K. Agot
          1. UNIM Project, Kenya
            1. J.O. Ndinya-Achola
            1. University of Nairobi, Kenya
              1. W. Hogrefe
              1. Focus Diagnostics, United States
                1. R. Morrow
                1. University of Washington, United States
                  1. S. Moses
                  1. University of Manitoba, Canada

                    Abstract

                    Background: In certain parts of Africa, type-specific HSV type-2 ELISAs may have limited specificity. To date, no study has been conducted to validate HerpeSelect and Kalon type-specific HSV-2 ELISAs using both the Western blot (WB) and Recombinant gG ELISA inhibition testing as reference standards.

                    Methods: A total of 120 HIV-seronegative men (aged 18-24 years) provided blood samples. HSV-2 IgG serum antibodies were detected using four different methods: i. HerpeSelect HSV-2 ELISA (n=120), ii. Kalon HSV-2 ELISA (n=120), iii. University of Washington WB (n=101), and iv. a recombinant inhibition test (n=93).

                    Results: HSV-2 seroprevalence differed significantly by HSV-2 detection method, ranging from 24.8% with the WB to 69.8% with the HerpeSelect ELISA. Using the WB as the reference standard, the HerpesSelect had the highest sensitivity for HSV-2 antibody detection (100%), yet lowest specificity (40%). Similar results were obtained using the inhibition test as the reference standard. The sensitivity and specificity of the Kalon test were 92% and 79%, respectively, versus the WB; and 80% and 82% versus the inhibition test. Using the inhibition test as the reference standard, the sensitivity of the WB appeared low (49%).

                    Conclusions: In HIV-seronegative men in Western Kenya, the HerpeSelect and Kalon type-specific ELISAs had high sensitivities yet limited specificities using the WB as reference standard. Overall, the Kalon ELISA performed better than the HerpeSelect ELISA in these high-risk young men from Kisumu. Further understanding is needed for the interpretation of HSV-2 inhibition or ELISA test positive/WB seronegative results. Before HSV-2 seropositivity may be reliably reported in selected areas of Africa, performance studies of HSV-2 serological assays in individual geographical areas are recommended.

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