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February 24, 1989

Rapid Screening Tests for HIV

JAMA. 1989;261(8):1148. doi:10.1001/jama.1989.03420080061016

To the Editor. —  The report1 on the rapid latex agglutination test for human immunodeficiency virus (HIV) screening, using a novel recombinant envelope glycoprotein of human immunodeficiency virus, is encouraging because of its low cost, operational simplicity, and excellent sensitivity and specificity in comparison with Western blot results. Nevertheless, the encouraging findings on HIV screening among 1600 consecutive potential blood donors, tested by recently trained Zairian technicians, should not lead to universal acceptance of the latex agglutination system in the vast developing areas of Africa, Latin America, and Asia, where even the performance of otherwise efficient immunobiologicals has continued to be dismal. High ambient temperatures far exceeding 40°C, marked diurnal variation in sunlight, and humidity and drought that are a rule rather than exception in such areas have all been incriminated in the continuing failure of immunobiologicals.2 Similar mishaps with otherwise promising diagnostic reagents for AIDS for such