Evaluation of ten commercial heterophile antibody tests for infectious mononucleosis

Abstract

Ten rapid slide agglutination tests for infectious mononucleosis were evaluated. The quality of the technical information included with the kits was found to differ considerably, as did the composition of the tests and the principles of test specificity. Furthermore, large variation was found in the shelf life and price of the different kits. Thirty-nine serum samples were selected according to titre in the Paul-Bunnell-Davidsohn differential absorption test, largely from the low titre area, since this is where most diagnostic problems can be expected. The sera were tested blindly using the ten rapid slide agglutination tests. Considerable differences were found in specificity and sensitivity. When compared with the results obtained from PBD, the tests could be divided into two groups. The first group consisted of three kits, all of which gave false negative, but no false positive results. The remaining seven tests gave false negative and false positive results, but were more sensitive than the tests in the first group. The large variation in the results obtained when using the different kits under controlled conditions indicates that such tests may give even less satisfactory results in practice.