T-lymphocyte immunophenotyping blind proficiency testing: a model system for CD4+ T-cells.

Objective: To develop and evaluate methods and results for blind proficiency testing for CD4+ T-cells by T-lymphocyte immunophenotyping.

Design: A model system was developed to submit duplicate specimens for T-lymphocyte immunophenotyping as if they were routine patient specimens rather than proficiency specimens. Testing results were compared both interlaboratory and intralaboratory.

Physician satisfaction with human immunodeficiency virus type 1 and hepatitis B virus testing in San Diego County.

Physician satisfaction with the laboratory testing process is one indicator of the physician's perception of the quality of laboratory testing and the effectiveness of the communication of the laboratory results. This study compares the level of satisfaction of physicians reporting their experience with human immunodeficiency virus type 1 (HIV-1) testing with the satisfaction levels of those physicians reporting their experience with hepatitis B virus (HBV) testing. By mail, 6,570 licensed San Diego County physicians were surveyed.

Variability of reporting and lack of adherence to consensus guidelines in human T-lymphocyte immunophenotyping reports: results of a case series.

Percentages and absolute counts of CD4+ lymphocytes, as determined by T-lymphocyte immunophenotyping (TLI), are prognostic, as well as diagnostic, of the course of human immunodeficiency virus type 1 infections and are important indicators for initiating Pneumocystis carinii pneumonia prophylaxis and antiretroviral therapy. In December 1990, we requested that a nonrandom sample of 17 laboratories provide us with typical reports of their TLI results from an immunodeficient patient and from a patient whose TLI results were within the laboratory's normal reference ranges. We also searched published literature and documents proposed by professional organizations for recommendations regarding T-lymphocyte testing and reporting.

Use of a modified nominal group process for improving laboratory performance in human immunodeficiency virus type 1 antibody testing. Reaching consensus on three questions concerning HIV-1 testing.

Using expert panels of medical technologists and public health microbiologists, a modified nominal group process was used to reach a consensus on three questions concerning current human immunodeficiency virus type 1 (HIV-1) testing methods. The questions related to important sources of error, improving the testing process, and improving proficiency testing. The modified nominal group process proved to be effective in developing lists of errors in laboratory testing; it provided a fast, economic means of identifying possible areas for improving laboratory quality assurance and training programs.

Content and design of laboratory report forms for human immunodeficiency virus type 1 antibody testing.

In a pilot study involving proficiency testing for human immunodeficiency virus, markedly diverse and potentially confusing test report forms were encountered among participating laboratories. Therefore, a comprehensive study of human immunodeficiency virus type 1 report forms was conducted from state-licensed testing laboratories in California. Participants analyzed three serum samples of known human immunodeficiency virus type 1 antibody reactivity and reported their results on forms that they would normally submit to clinicians.

Prevalence of human T cell lymphotropic virus types 1 and 2 (HTLV-1/2) in selected Tijuana subpopulations.

To assess the prevalence of human T cell lymphotropic virus type 1 and 2 (HTLV-1/2) infections among potentially high-risk populations in the city of Tijuana, Mexico, the prevalence of specific antibodies was determined and information on risk behaviors was obtained between June and October 1988. The study involved 631 presumably healthy individuals, randomly selected from a study population recruited sequentially from prisoners, prostitutes, and injecting drug users (IDUs), and randomly from homosexual and bisexual men. The presence of HTLV-1/2 antibodies was determined by enzyme immunoassay and an immunofluorescence method, and positive reactions were confirmed by a radioimmunoprecipitation assay and Western blot.

Identification of nonanalytic issues in HIV-1 antibody testing using blind proficiency testing.

Blind proficiency testing was used to examine nonanalytic performance indicators for human immunodeficiency virus type 1 (HIV-1) antibody testing. Physician offices, clinics, and hospitals located throughout Southern California submitted simulated patient specimens to laboratories as routine test requests. A total of 32 laboratories were involved during five blind proficiency testing surveys.

Analytic results of HIV-1 testing using blind proficiency testing.

The use of blind proficiency testing (PT) to examine analytic performance of human immunodeficiency virus type 1 (HIV-1) antibody testing. A total of 32 hospital, blood bank, public health, and commercial laboratories were included in this study. Test sera were introduced as clinical specimens for HIV-1 testing from private practitioners, group practices, clinics, and hospitals in Southern California.

Methods for a model blind proficiency testing system.

The method developed for establishing a blind proficiency testing (PT) system is presented. The Laboratory Assurance Program of the Graduate School of Public Health at San Diego State University is developing and pilot testing innovative strategies that will evaluate and improve the performance of clinical laboratories. To date, a total of 32 laboratories have been incorporated into this program along with 12 counseling and testing sites.

HTLV-I among U.S. Marines stationed in a hyperendemic area: evidence for female-to-male sexual transmission.

Among 5,255 active duty United States Marines on permanent tour in Okinawa, Japan, screened for human T-cell leukemia/lymphoma virus type I (HTLV-I) seropositivity, 3 (0.06%) were confirmed by Western blot analysis to have core and envelope reactivity. All three seropositive individuals have a history of prolonged sexual contact with Okinawan women, and two of the three individuals are married to seropositive Okinawan wives.

[Development of a rehydration therapy in diarrheic disease. 1980].

Intravenous rehydration is required only in patients with severe diarrhea due to V. cholerae who are in shock, with absent peripheral pulse and blood pressure; when the shock has been corrected, rehydration can be completed using an oral rehydration solution. The intravenous solution to be used is 5:4: 1 (5g of sodium chloride, 4g of sodium bicarbonate and 1g of potassium chloride per liter) or a comparable commercial alkaline solution.

The laboratory diagnosis of HIV infection.

Testing for HIV is a procedure with possible dire consequences; hence, reports should not be rendered to the patient without appropriate counseling. And this must be based on firm information whether the individual is truly infected if the report is positive. The reactive results of the EIA screening test should always be confirmed by supplemental testing.

HIV-1 prevalence in selected Tijuana sub-populations.

To assess the prevalence of HIV-1 (human immunodeficiency virus) infection among high-risk populations in Tijuana, Mexico, HIV-1 antibody status was determined and information on risk behavior was obtained from 1,069 individuals in three high-risk groups. The prevalence of HIV-1 among 415 prostitutes was 0.5 percent; 410 prisoners, 1.

Prevention of hepatitis B transmission in Indo-Chinese refugees with active and passive immunization.

Hepatitis B is a cause of disability and death worldwide, with high rates of perinatal transmission in third world countries, including those of Indochina. Prevention of transmission by active and passive immunization has been available since 1982. This study looked at the serological response of Indo-Chinese refugees to these products in an outpatient primary care clinic and at the compliance problems found in this setting.

Chlamydia trachomatis urethritis in university men: risk factors and rates.

This study reports the rates of Chlamydia trachomatis genital infection in two groups of university men. One hundred twenty-seven came to the student health center with genitourinary complaints, and 29 were identified as the sexual partners of women with chlamydia infections. Evidence of chlamydial infection was found in 29 (22.

Reporting the results of human immunodeficiency virus testing.

We conducted a pilot study of potential sources of incorrect laboratory reports of human immunodeficiency virus type 1 testing using blind proficiency testing. Sets of three serum samples, including one serum sample with negative reactions in antibody tests, one serum sample with positive reactions, and one that gave false-positive results with certain testing kits, were sent as routine patient specimens to testing laboratories. Half the laboratories reported the serum sample positive for human immunodeficiency virus antibodies as "indeterminate"; one laboratory rendered a final positive report without supplemental testing.

AIDS update.

Acquired immunodeficiency syndrome (AIDS) is a new and frightening epidemic. Epidemiology has clearly delineated the mechanisms of spread as sexual intercourse, transfer of blood, and vertical transfer from infected mother to newborn child. Although much remains to be answered about infection with the AIDS virus, present information will allow containment of its spread while methods of controlling the threat, such as development of vaccine and therapy, are vigorously pursued.