Acute HIV revisited: new opportunities for treatment and prevention
J. Clin. Invest. Christopher D. Pilcher, et al. 113:937 doi:10.1172/JCI21540 [Go to this article.]

Figure 2
Specimen pooling for HIV RNA testing. The algorithm shown here is that used by the North Carolina State Laboratory of Public Health to increase the predictive accuracy and cost efficiency of the screening of all sera, obtained through HIV voluntary counseling and testing, that are initially antibody-negative for HIV RNA. (A) Illustration of the creation of intermediate and master pools in a 1:10:90 pyramid-style pooling scheme. Only HIV-seronegative specimens are pooled. In each step, 200-μl aliquots are drawn off for pooling. The master pool ultimately contains sera from 90 antibody-negative individuals. (B) Illustration of the manner in which pools are screened using HIV RNA amplification testing. Positive results on a master pool trigger testing of intermediate pools and, in the final round of testing, individual specimens. When only a small number of specimens in a population are truly HIV RNA–positive, this procedure results in a dramatic reduction in the number of RNA tests used and virtually eliminates false-positive RNA test results in the final round of testing. Figure reprinted with permission from Journal of the American Medical Association (16).