Evaluation of the interpretation criteria of Western Blot profiles for the HIV-1 infection diagnosis in a South Moroccan group


Western Blot Method
Interpretation criteria
Indeterminate profiles


How to Cite

Chadli S, Ait Said H, Fadil FZ, Benlmeliani F, Sardi J, Kharbouch S, Hassaini N, El Bassbassi M, Taqarort N, Oulkheir S, Aghrouch M. Evaluation of the interpretation criteria of Western Blot profiles for the HIV-1 infection diagnosis in a South Moroccan group: Sensitivity, specificity and predictive values of HIV-1 Western Blot method in a South Moroccan group. Integr J Med Sci [Internet]. 2020 Feb. 19 [cited 2021 Dec. 1];7. Available from: https://www.mbmj.org/index.php/ijms/article/view/125


Introduction : Western Blot (WB) is the most commonly used method to confirm the presence of antibodies against Human Immunodeficiency Virus type 1 (HIV-1). The interpretation of WB, however, poses difficulties since of the multiplicity of criteria proposed by various international organizations. Some criteria generate an unacceptable number of indeterminate results, thus preventing the early management of patients. The present work aims to evaluate the different criteria for interpretation of WB according to various organizations compared to viral load test.
Material and methods : This is a study carried out on a total of 2 618 Western Blot profiles registered during a period of 56 month (from January 2013 to September 2017) at the Laboratory of Medical Analysis of Regional Hospital Center in Agadir.
Results : The results obtained indicate that some organizations have very interesting values concerning the positivity of the WB profiles; WHO (94.84%), CDC/ ASTPHLD (94.61%) and SFTS (93.09%). For the negative profiles, all the organizations have identical values with 3.59%. Regarding indeterminate profiles, the WHO gave the minimum of these cases (1.57%) followed by CDC / ASTPHLD (1.8%) and SFTS (3.32%). The WHO provided very interesting values for sensitivity (98.93%), specificity (91.26%), positive predictive value (99.64%) and negative predictive value (74.60%). Similarly, the CDC / ASTPHLD criteria remain favorable and are highly consistent with those of WHO (p = 0.8113).
Conclusion : Sensitivity, specificity, and predictive values are characteristics of WB test that interpret the results and allow applying them to patients. In our context, it is recommended to adopt the WHO criteria to facilitate the interpretation of western blot profiles. The CDC / ASTPHLD criteria remain favorable to adoption.



Joint United Nations, Programme on HIV/AIDS (2017). UNAIDS Data 2017. Geneva, Switzerland. [Accessed 2021 Aug 26]. Available from: http://www.unaids.org/sites/default/files/media_asset/20170720_Data_book_2017_en.pdf

Ministère de la santé avec l’appui de Fonds Mondial (2017). JM Sida 2017, réalisations et perspectives. Maroc. [Accessed 2021 Aug 26]. Available from : http://www.sante.gov.ma/Documents/2017/11/JMS%202017%20BROCHURE%20fr.pdf

Ministère de la santé. Plan stratégique national de lutte contre le sida; 2012—2016, Maroc.

Chadli S, Aghrouch M, Taqarort N, Malmoussi M, Ouagari Z, Moustaoui F, et Al. [Neuromeningeal cryptococcosis in patients infected with HIV at Agadir regional hospital, (Souss-Massa, Morocco)]. J Mycol Med. 2018 Mar; 28 (1):161-116. https://doi.org/10.1016/j.mycmed.2017.10.006.

Admou B, Zougaghi L, Soraa N, Amine A, Tassi N, Kachach M, et al. HIV-1 western-blot patterns and clinical stages in a Moroccan population. Rev Franco Labora, 2009 Nov; 2009 (416): 19-22. https://doi.org/10.1016/S1773-035X(09)70270-9

World Health Origanisation . AIDS: proposed criteria for interpreting Western Blot assays for HIV-1, HIV-2, and HTLV 1/HTV-II. Bulletin of the WHO. 1991 ; 69 (1): 127-130.

Centers for Disease Control. Interpretation and Use of the Western Blot Assay for Serodiagnosis of Human Immunodesficiency Virus Type 1 Infection. MMWR. 1989; 38 (S-7): 1-7.

Sandler SG, Dodd RY, Fang CT. Diagnostic tests for HIV infection: Serology. In: DeVita VT, Hellman S, Rosenberg SA, eds. AIDS: Etiology, Treatment, and Prevention, Second Edition. Philadelphia: J.B. Lippincott. 1988; 121-126.

Koeck J-L, Dubrous P, Coulot P, Blanchard de Vaucouleurs A. Problèmes posés par l'interprétation des tests western-blot VIH-1 en 1997. Rev Française Lab. 1997 Jun; 1997 (294): 69-73. https://doi.org/10.1016/S0338-9898(97)80198-9

McKenna, S.J. Serological diagnosis of human immunodeficiency virus infection by Western blot testing: The Consortium for Retrovirus Serology Standardization. Carlson JR. JAMA 260: 674. J Oral Maxillofacial Surg. 1989 Apr 1; 47 (4): 429-430. https://doi.org/10.1016/0278-2391(89)90360-1

Du Pont Diagnostics Company. Human immunodeficiency virus (HIV): Biotech/Du Pont HIV western blot kit for detection of antibodies to HIV. Wilmington, Delaware, 1987.

Hausler WJ Jr. Report of the Third Consensus Conference on HIV Testing Sponsored by the Association of State and Territorial Public Health Laboratory Directors. Infect control Hosp Epidemiol. 1988 Aug; 9 (8): 345-9. https://doi.org/10.1086/645875

Syed Iqbal H, Balakrishnan P, Sunil S, Murugavel KG, Kumarasamy N, Vidya S, et al. HIV-1 Western Blot Assay: What determines an indeterminate status? Indian J Med Sci. 2005 Oct; 59 (10): 443-50. https://doi.org/10.4103/0019-5359.17051

Meles H, Wolday D, Fontanet A, Tsegaye A, Tilahun T, Aklilu M, et al. Indeterminate Human Immunodeficiency Virus Western Blot Profiles in Ethiopians with Discordant Screening-Assay Results. Clin Diagn Lab Immunol. 2002 Jan; 9(1): 160-3. http://doi.org/10.1128/CDLI.9.1.160-163.2002.

Kouyoumjian SP, Mumtaz GR, Hilmi N, Zidouh A, El Rhilani H, Alami K, et al. The epidemiology of HIV infection in Morocco: systematic review and data synthesis. Int J STD AIDS. 2013 Jul; 24(7): 507–16. http://doi.org/10.1177/0956462413477971

El Harti E, El Aouad R, Amzazi S, Himmich H, Elhachimi Z, Apetrei C, et al. HIV-1 diversity in Morocco. Aids. 1997 Nov 15; 11(14):1781-3.

Lihana RW, Ssemwanga D, Abimiku A, Ndembi N. Update on HIV-1 diversity in Africa: a decade in review, AIDS Review. Apr-Jun 2012; 14 (2):83-100.

Ndjoyi-Mbiguino A, Bélec L. Évaluation de trousses de dépistage de l’infection à VIH au Gabon. Cahiers d'études recherches franco / Santé. Jan- Fev- Mar 2005 ; 15 (1) : 23-29.

Weng K-C, Ho S-Y, Chang S-Y. Clinical experiences in interpretation of HIV-1 Western blot indeterminate results. J Microbiology, Immunology Infection. 2015; 48 (2), S134. https://doi.org/10.1016/j.jmii.2015.02.471

Ravanshad M, Mahboudi F, Sabahi F, Bayanolhagh S. Indeterminate human immunodeficiency virus western blot results in Iranian patients with discordant screening assay results. Saudi Med J. 2006 Aug; 27(8):1130-1133.

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