Risk Factors for Repeatedly Reactive HIV-1 EIA and Indeterminate Western Blots

Abstract

Evaluation of persons with reactive HIV-1 enzyme immunoassays and IWB should include an assessment of HIV risk and other possible risk factors, such as alloimmunization (ie, parity or recent immunization) or autoantibodies (ie, antinuclear antibodies and rheumatoid factor). The relationship of IWB among men who reported sex with prostitutes is intriguing and warrants further study.

Evaluation of the Rapid Immunoassay Determine HIV 1/2 for Detection of Antibodies to Human Immunodeficiency Virus Types 1 and 2

“…Two patients with a false-positive MEIA had concomitant infections (an acute cytomegalovirus infection and an amebic liver abscess) that might be the cause of the false-positive results. False-positive enzyme-linked immunosorbent assays have been described before (3,4,6,7), and cross-reactivity is one of the known causes. A false-negative MEIA did not occur.…”

A combined HIV‐1 protein bead array for serology assay and T‐cell subset immunophenotyping with a hybrid flow cytometer: A step in the direction of a comprehensive multitasking instrument platform for infectious disease diagnosis and monitoring

“…One caveat of the Western blot is the occurrence of false negative results, in cases of recent infection or false positive results caused in some cases by the presence of cross-reactive antibodies (29)(30)(31)(32). New immunoblot assays have been developed using recombinant HIV-1/2 proteins and peptides (26)(27)(28).…”

HIV-1 western blot assay: What determines an indeterminate status?

“…However the one drawback of the WB is the indeterminate result. [1,6,[9][10][11]15,24,[26][27][28] Measures are needed to restrict indeterminate results only to the patients who are in the window period. A large prospective study is needed with application of different kits and a large specimen size may be helpful to choose superior HIV diagnostic aids.…”

“…Besides this, HIV-2 cross reaction, contaminating cellular antigens on viral lysate based blot strips, infection with human T-cell lymphotrophic virus I/II (HTLV I/II), auto antibodies, pregnancy, abnormal bilirubin levels and in-vitro hemolysis have also been suggested as possible causes of indeterminate WB status. [6][7][8] Previous studies have indicated that approximately 20-30% of HIV-1 ELISA negative and 4-20% of HIV-1 ELISA positive specimens have indeterminate results by WB assay. [9][10][11][12] The problems with indeterminate results are myriad.…”

“…All these assay runs were validated by internal quality control provided by the manufacturer. The Western blot results were read primarily with the criteria provided by the manufacturer than they were also analyzed different widely used interpretation criteria: [6,17] Centre for disease control (CDC)/ Association of State and Territorial Public Health Laboratory Directors (ASTPHLD), World Heath Organization (WHO)/National AIDS Control Organization (NACO, India), American Red Cross (ARC), American Food and Drug Administration (FDA), Consortium for retrovirus serology standardization (CRSS), [18] John Hopkins University (JHU). As we found discrepancies in our results for some of the specimens run on both the LAV BLOT I and the Genetic systems kits, we randomly selected 5 among the 23 specimens and subjected them to a HIV RT-PCR (NeoDin TM HIV type-I RT-PCR Kit, NEODIN Co., Ltd. Korea) for confirmation.…”