Letter to the editor: additional evidence to support a cross-reactivity of SARS-CoV-2 with HIV chemiluminescent assay

Cipitelli, Márcio da Costa; Dornelas-Ribeiro, Marcos; Santos, Caleb Guedes Miranda dos

doi:10.1136/jclinpath-2021-207813

Cited by 3 publications

(7 citation statements)

References 5 publications

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“…This study adds support to previous publications reporting an increase in HIV false-positive results during and after COVID-19 pandemic [10–14] and gives support to consider SARS CoV-2 infection among possible causes of false-positive ELISA results, as they exhibited the same rate observed in other conditions not linked to the HIV infection [5]. The reporting of this finding is crucial to inform health authorities and should be dispersed along with virology testing providers.…”

Section: Discussionsupporting

confidence: 82%

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Increased risk of false-positive HIV ELISA results after COVID-19

Alfie

Longueira

Pippo

et al. 2023

Aids

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Objective: From the first-generation options available in 1985, tests to detect HIV-1 specific antibodies have increased its sensitivity and specificity. HIV-1 and SARS-CoV-2 surface glycoproteins present a certain degree of homology and shared epitope motifs, which results of relevance as both pandemics coexist. Here, we aimed to evaluate the rate of false-positive HIV serology results among individuals with COVID-19 diagnosis and in vaccinated individuals. Design: A retrospective analysis of the samples stored at the Infectious Disease Biobank in Argentina from donors with previous COVID-19 diagnosis or anti-SARS-CoV-2 vaccination. Methods: Plasma samples were analyzed using Genscreen Ultra HIV Ag-Ab. In those with a positive result, the following assays were also performed: ELISA lateral flow Determine Early Detect; RecomLine HIV-1 & HIV-2 IgG and Abbott m2000 RealTime PCR for HIV-1 viral load quantification. In all samples, the presence of anti-SARS-CoV-2 IgG antibodies was evaluated by ELISA using the COVIDAR kit. Statistical analysis was done using Pearson's and Fisher's exact chi-squared test; Mann–Whitney and Kruskal–Wallis tests. Results: Globally, the false-positive HIV ELISA rate was 1.3% [95% confidence interval (95% CI) 0.66–2.22; χ 2 = 4.68, P = 0.03, when compared with the expected 0.4% false-positive rate]. It increased to 1.4% (95% CI 0.70–2.24, χ 2 = 5.16, P = 0.02) when only samples from individuals with previous COVID-19 diagnosis, and to 1.8% (95% CI 0.91–3.06, χ 2 = 7.99, P = 0.005) when only individuals with detectable IgG SARS-CoV-2 antibodies were considered. Conclusion: This higher occurrence of HIV false-positive results among individuals with detectable antibodies against Spike SARS-CoV-2 protein should be dispersed among virology testing settings, health providers, and authorities.

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Section: Discussionsupporting

confidence: 82%

“…HIV and SARS-CoV surface glycoproteins present a certain degree of homology and shared epitope motifs [9]. Indeed, there have been several reports in 2020 and 2021 of false-positive results in HIV screening assays in individuals with acute or past SARS CoV-2 infection [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Increased risk of false-positive HIV ELISA results after COVID-19

Alfie

Longueira

Pippo

et al. 2023

Aids

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“…The work of other researchers linked an acute SARS-CoV-2 infection to HIV test reactivity and suggested but did not demonstrate the presence of cross-reactive Abs [ 15 , 17 , 18 , 19 , 20 ]. SARS-CoV-2 spike-specific IgM peaks 2–5 weeks after the onset of symptoms [ 31 , 32 ] but decays quickly.…”

Section: Resultsmentioning

confidence: 99%

“…In addition to the previously recognized interfering reagents, three cohort studies found that coronavirus disease (COVID-19) was significantly associated with false-positive results in the fourth-generation HIV screening tests Elecsys HIV Duo (Roche) [ 14 , 15 ] and Genscreen Ultra HIV Ag-Ab (Bio-Rad) [ 16 ]. Further, severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2)-associated HIV test reactivity was linked in case studies to additional HIV screening tests including Elecsys HIV Combi PT (Roche) [ 17 ], VIDAS HIV Duo Ultra (BioMérieux) [ 18 ], Vitros HIV combo (Ortho Clinical Diagnostics) [ 19 ], Architect HIV Ag/Ab Combo (Abbott) [ 18 , 20 , 21 ], or unspecified tests [ 22 , 23 ]. In all cases, confirmatory immunoblots for HIV Abs and/or qPCRs for HIV RNA were negative.…”

Section: Introductionmentioning

confidence: 99%

“…Both the SARS-CoV-2 spike and HIV envelope (Env) are class 1 fusion machineries, require furin cleavage to generate their surface (S1/gp120) and transmembrane (S2/gp41) subunits, and are heavily glycosylated [ 25 ]. Based on these structural similarities, several authors proposed SARS-CoV-2 spike/HIV Env cross-reactive Abs as an explanation for the observed false-reactive HIV screening tests post SARS-CoV-2 infection [ 15 , 17 , 18 , 19 , 20 ]. No attempt has yet been made to demonstrate the existence of this type of Abs in patient sera with HIV test interference; however, vaccination of mice with spike-induced Abs capable of binding the HIV gp41 membrane-proximal external region (MPER) suggests that induction of HIV cross-reactive Abs by SARS-CoV-2 is possible [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

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False-Positive Screening and Confirmatory HIV Diagnostic Test in a Patient with Cured SARS-CoV-2 Infection Is Not Mediated by Env/Spike Cross-Reactive Antibodies

Elsner,

Appeltrath,

Konik

et al. 2023

Viruses

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Acute SARS-CoV-2 infection has been associated with false-positive HIV screening tests. The underlying mechanism is unclear, and for clinical cases, evidence beyond a temporal connection is missing. However, several experimental studies point toward SARS-CoV-2 spike/HIV-1 envelope (Env) cross-reactive antibodies (Abs) as a cause. Here, we present the first case of an individual with convalescent SARS-CoV-2 infection testing false positive in both an HIV screening and confirmatory test. Longitudinal sampling showed that the phenomenon was temporary but lasted for at least 3 months before waning. After excluding a multitude of common determinants for assay interference, we further show by antibody depletion studies that SARS-CoV-2-spike-specific Abs did not cross-react with HIV-1 gp120 in the patient sample. No additional case of HIV test interference was identified in a cohort of 66 individuals who presented to a post-COVID-19 outpatient clinic. We conclude the SARS-CoV-2-associated HIV test interference to be a temporary process capable of disturbing both screening and confirmatory assays. The assay interference is short-lived and/or rare but should be considered by physicians as a possible explanation for unexpected HIV diagnostic results in patients with a recent SARS-CoV-2 infection.

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COVID-19 impact on blood donor characteristics and seroprevalence of transfusion-transmitted infections in southern Thailand between 2018 and 2022

Burananayok,

Nachatri,

Choothanorm

et al. 2024

Sci Rep

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Blood safety is a critical aspect of healthcare systems worldwide involving rigorous screening, testing, and processing protocols to minimize the risk of transfusion-transmitted infections (TTIs). The present study offers a comprehensive assessment of the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and syphilis among blood donors in southern Thailand. It explores the consequences of the COVID-19 pandemic on the blood transfusion service, donor characteristics, and the prevalence of TTIs. A retrospective analysis of 65,511 blood donors between 2018 and 2022 was conducted at Songklanagarind Hospital, Thailand. The socio-demographic characteristics of the donors were examined using the Chi-square test to assess the relationship between TTIs serological positivity and donor characteristics. The donors were divided into pre-COVID-19 (2018–2019) and during COVID-19 (2020–2022) groups to evaluate the impacts of COVID-19. The study found that HBV had the highest overall prevalence at 243 per hundred thousand (pht), followed by syphilis (118 pht), HCV (32 pht), and HIV (31 pht) over a five-year period of study. After COVID-19, the prevalence of HBV decreased by 21.8%; HCV decreased by 2.1%; HIV increased by 36.4%; and syphilis increased by 9.2%. The socio-demographic characteristics and TTIs prevalence were significantly altered over time. This study provides insights into blood donor characteristics and TTIs prevalence in southern Thailand, highlighting the understanding of the impact of COVID-19 on the spread of TTIs.

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Letter to the editor: additional evidence to support a cross-reactivity of SARS-CoV-2 with HIV chemiluminescent assay

Cited by 3 publications

References 5 publications

Increased risk of false-positive HIV ELISA results after COVID-19

Increased risk of false-positive HIV ELISA results after COVID-19

False-Positive Screening and Confirmatory HIV Diagnostic Test in a Patient with Cured SARS-CoV-2 Infection Is Not Mediated by Env/Spike Cross-Reactive Antibodies

COVID-19 impact on blood donor characteristics and seroprevalence of transfusion-transmitted infections in southern Thailand between 2018 and 2022

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