Absence of HIV infection in blood donors with indeterminate western blot tests for antibody to HIV-1.
To determine whether apparently healthy persons who have had repeatedly reactive enzyme immunoassays and an indeterminate Western blot assay for antibody to the human immunodeficiency virus type 1 (HIV-1) are infected with HIV-1 or HIV-2, we studied 99 such volunteer blood donors in a low-risk area of the country. The subjects were interviewed about HIV risk factors. Coded blood specimens were tested again for HIV-1 antibody (by two different enzyme immunoassays, a Western blot assay and a radioimmunoprecipitation assay) and for HIV-2 antibody by enzyme immunoassay, for HIV-1 by the serum antigen test, for HIV-1 by culture, for human T-cell leukemia virus Type I or II antibody by enzyme immunoassay, and for sequences of HIV DNA by the polymerase chain reaction. Of the 99 blood donors, 98 reported no risk factors for HIV-1 infection; 1 donor had used intravenous drugs. After a median of 14 months (range, 1 to 30) from the time of the initial test, 65 subjects (66 percent) were still repeatedly reactive for HIV-1 antibody on at least one immunoassay. In 91 subjects (92 percent) the Western blot results were still indeterminate, whereas in 8 they were negative. No donor met the criteria for a positive Western blot assay for HIV-1, and none had evidence of HIV-1 or HIV-2 infection on culture or by any other test. We conclude that persons at low risk for HIV infection who have persistent indeterminate HIV-1 Western blots are rarely if ever infected with HIV-1 or HIV-2.
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.
J B
JB
Jackson
K L
KL
MacDonald
J
J
Cadwell
C
C
Sullivan
W E
WE
Kline
M
M
Hanson
K J
KJ
Sannerud
S L
SL
Stramer
N J
NJ
Fildes
S Y
SY
Kwok
D000328:Adult; D001483:Base Sequence; D001782:Blood Donors; D015153:Blotting, Western / Q000592:standards*; D003710:Demography; D005260:Female; D015483:HIV Antibodies / Q000032:analysis*; D015658:HIV Infections / Q000175:diagnosis*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D015531:Radioimmunoprecipitation Assay; D012307:Risk Factors
D015483:HIV Antibodies