Frequency, Causes, and New Challenges of Indeterminate Results in Western Blot Confirmatory Testing for Antibodies to Human Immunodeficiency Virus

Guan, Ming

doi:10.1128/cvi.00393-06

Cited by 41 publications

(37 citation statements)

References 97 publications

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“…Overall HIV prevalence of 2.9% among the prospective blood donors was confirmed. This is similar to 2.92% found by Glynn et al [15], and nearly 5-fold the findings of Mavenyengwa et al [16] who reported HIV prevalence of 0.6% among voluntary blood donors in Namibia [16] and slightly lower than 3.1% seroprevalence reported by Buseri et al [8] Typically, rapid techniques and ELISA have been the most common techniques adopted in blood donor screening [17]. These results showed the effectiveness of alternative rapid enzyme immunoassay serial algorithm as well as the combined rapid EIA-ELISA algorithm in blood donor screening and HIV diagnosis in resource limited settings [27].…”

Section: Discussionsupporting

confidence: 74%

“…Despite this advocacy, majority of blood donors in resource-limited settings are replacement blood donors and paid blood donors which are associated with higher risks of transmitting bloodborne infections including HIV. Several studies have documented the prevalence of HIV infections in prospective blood donors in various regions of the world [8,[12][13][14][15][16][17]. Transfusion of blood and blood products has been reported to account for 5-10% of HIV transmission in sub-Saharan Africa [18,19].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of Human Immunodeficiency Virus in Prospective Blood Donors and Testing Algorithm Assessment with Real-Time PCR for Optimal Blood Safety Practice

KA¹

2017

HTIJ

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Background: The challenge of 'safe blood' practice has given rise to several unanswered questions in the practice of immune-hematology and has led to controversies as to which algorithm adopted for HIV testing in prospective blood donors pose the least risk and provide safe blood to recipients of blood transfusion. The aim of this study is to evaluate HIV epidemiology and the outcomes of CDC-UMD serial algorithm II for HIV antibody testing in our resource-limited setting by advancing HIV screening beyond serologic procedure. Material and Methods:A total of 140 prospective blood donors were enrolled in the study between November, 2014 and July, 2015 by consecutive sampling technique. Study used HIV antibody screening based on serial algorithm II as the first-line testing protocol followed by ELISA technique. HIV-DNA confirmation and HIV-RNA quantification were carried out on pooled DBS and plasma samples respectively using real-time PCR. Results:The overall mean age and gender ratio of PBD were 27.9±7.9 years and 1.1:1. Chi square analysis revealed that the PBD had the right knowledge of all the routes of HIV transmission (χ2 range: 63.3 -212.7, p< 0.05). Study showed an overall HIV prevalence of 2.9% irrespective of assay technique with intercategory variation in prevalence. Pooled sero-negative DBS samples analysis by real-time PCR showed absence of occult HIV infection among PBD and viral load of confirmed positive blood donors revealed low viraemia (least being 25copies/ mL). Conclusion:Based on the study findings, HIV rapid antibody testing based on serial algorithm II did not compromise 'safe blood practice'. Adoption of rapid HIV antibody techniques based on serial algorithm II can serve as a surrogate HIV confirmatory technique in PBD where facilities for ELISA or the more costly realtime PCR are unavailable.

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Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Epidemiology of Human Immunodeficiency Virus in Prospective Blood Donors and Testing Algorithm Assessment with Real-Time PCR for Optimal Blood Safety Practice

KA¹

2017

HTIJ

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“…Nucleic acid testing (NAT) for HIV is also used when a rare HIV genotype is suspected; such testing plays a critical role in neonatal HIV screening, owing to interference from maternal antibodies. Besides early seroconversion, other causes of indeterminate HIV-1 WB results in the setting of HIV infection include infection with HIV-2 and advanced AIDS (6 ). An indeterminate WB result can also arise from antibodies that are cross-reactive to HIV antigens, such as those associated with HTLV infection; with vaccination against influenza, hepatitis, or rabies; or with animal handlers exposed to unusual viruses.…”

Section: Discussionmentioning

confidence: 99%

“…Nonspecific antibody binding to nonviral cellular components in the WB HIV antigen preparation can also produce an indeterminate WB result. Such results may be associated with frequent transfusions, injection drug use, liver disease, multiple pregnancies, rheumatoid factor, lymphoma, multiple sclerosis, various autoimmune disorders, a positive result in the rapid plasma reagin test, and chronic hemodialysis (6 ).…”

Section: Discussionmentioning

confidence: 99%

“…This period is called the "seroconversion window." Because antibodies to p24 develop early during the course of infection, an indeterminate WB pattern seen during this window is often associated with an isolated p24 band (6 ). Qualitative reverse-transcription PCR analysis for HIV is used to screen for or confirm the presence of HIV infection during the seroconversion window, and the screen can become positive as early as 10 days after exposure (7 ).…”

Section: Discussionmentioning

confidence: 99%

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Interpretation of HIV Serologic Testing Results

Mahajan

Pace

Jarolím³

2010

Clinical Chemistry

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CASEA 33-year-old male patient visited the outpatient clinic at Brigham and Women's Hospital for a routine follow-up for obesity, obstructive sleep apnea, allergic rhinitis, and depression. He was maintained on a nocturnal continuous positive airway pressure device, loratadine, duloxetine, and fluticasone nasal spray. He was a resident of Boston and had not traveled outside the country. He denied intravenous drug use or highrisk sexual behavior, and he had not received any blood products. He had received his most recent influenza vaccine about 6 months earlier. He was screened for type 2 diabetes and hyperlipidemia. As a part of routine clinical care, he was also offered HIV screening in accordance with the current CDC recommendations (1 ).

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Human immunodeficiency virus in cadavers: A review

2019

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Millions of people are infected with human immunodeficiency virus (HIV); however, limited research focuses on post-mortem HIV detection. Post-mortem HIV testing is vital because medical records are not always available, and the HIV status can be unknown. The aims of this study were to review the available literature and determine the most efficient HIV test for post-mortem samples, the optimal tissue or bodily fluid to be tested, and the duration that HIV remains reliably detectable. A literature search was conducted using PubMed and Google Scholar. Terms were related to HIV (HIV detection, HIV testing, HIV prevalence) and deceased individuals (post-mortem, cadaver, deceased, organ donor). Inclusion criteria included English studies, or articles with at least an English abstract, while review articles were excluded. From this literature search, 43 studies were applicable. These studies most commonly used enzyme-linked immunosorbent assay and Western blot as screening and confirmation tests, respectively. As for the optimal tissue or bodily fluid, serum remained the golden standard, while testing skin seemed promising. HIV remains detectable in the body up to 58 days after death, although few studies tested samples after 48 h. Knowledge of the HIV status can be beneficial in the case of accidental exposure and can create a range of possible research opportunities on the effects of HIV in different organ systems. This review outlined several gaps in the current literature and future studies should investigate these gaps because this information can be relevant to numerous professions. Clin. Anat. 32:603-610, 2019.

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Frequency, Causes, and New Challenges of Indeterminate Results in Western Blot Confirmatory Testing for Antibodies to Human Immunodeficiency Virus

Cited by 41 publications

References 97 publications

Epidemiology of Human Immunodeficiency Virus in Prospective Blood Donors and Testing Algorithm Assessment with Real-Time PCR for Optimal Blood Safety Practice

Epidemiology of Human Immunodeficiency Virus in Prospective Blood Donors and Testing Algorithm Assessment with Real-Time PCR for Optimal Blood Safety Practice

Interpretation of HIV Serologic Testing Results

Human immunodeficiency virus in cadavers: A review

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