Early and specific diagnosis of seropositivity to HIVs by an enzyme-linked immunosorbent assay using env-derived synthetic peptides

We describe and evaluate the sensitivity and specificity of an enzyme-linked immunosorbent assay (ELISA) using a 22-amino-acid peptide corresponding to the carboxy-terminal end of HIV-1 gp120 and two 30-amino-acid long cyclic peptides including the two vicinal cysteines present on HIV-1 gp41 and on HIV-2 gp36. This test was evaluated. Data obtained with the Western blot (WB) and the peptide-based ELISA on a first panel composed of sera from 547 patients attending a specialized outpatient clinic (high-risk population) are in perfect agreement; moreover, 39 samples that had falsely been found positive with a viral lysate-based ELISA were not detected by peptide-based ELISA. The second panel was composed of 309 sera which were difficult to resolve using both WB and viral lysate-based ELISA. Using the peptide-based ELISA, 134 were found clearly positive and 173 clearly negative; only two were falsely positive. Finally, sera from 16 individuals examined at the time of seroconversion gave high absorbancy readings even if they were weakly reactive by WB (weak gp160 band). This test is thus highly sensitive and specific, and capable of detecting early seroconversion. It is also instrumental in clearly defining samples that are found indeterminate in the WB, and consequently it avoids the unnecessary follow-up required when a false-positive result is obtained using viral lysate-based ELISA.