title: Multiplex analysis of heterophil antibodies in patients with indeterminate HIV immunoassay results.
abstract: We hypothesized that heterophil antibodies reactive with animal proteins used in blot preparation caused nonspecific staining (NSS) on HIV Western blot (WB) studies, causing indeterminate results. We analyzed samples showing NSS on HIV WB using a multiplexed immunoassay to simultaneously measure IgG antibodies to animal IgG (bovine, goat, sheep, mouse) and bovine serum albumin. Heterophil antibodies reactive with IgG from several animal species were detected in 23 (49%) of 47 samples showing NSS on HIV WB; 15 positive samples demonstrated antibodies to all 5 antigens. Similar IgG heterophil antibodies were detected in only 2 (8%) of 24 control samples. Of the HIV WB samples with a positive HIV-1 enzyme-linked immunosorbent assay (ELISA) result at the time of WB testing (11/47), heterophil antibodies were found in 8 (73%) of 11. Preabsorption with bovine, goat, and sheep IgG removed heterophil antibodies detected by the multiplexed assay and, in some cases, eliminated reactivity in ELISA and WB testing. Heterophil antibodies are associated with indeterminate HIV immunoassay results and are an important cause of false-positive HIV ELISA results. Multiplexed immunoassays provide a powerful tool for screening patients for heterophil antibodies and resolving possible false-positive results.
authors.affiliation: Associated Regional and University Pathologists (ARUP), Institute for Clinical and Experimental Pathology, University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: J H
authors.initials: JH
authors.lastname: Willman
authors.forename: H R
authors.initials: HR
authors.lastname: Hill
authors.forename: T B
authors.initials: TB
authors.lastname: Martins
authors.forename: T D
authors.initials: TD
authors.lastname: Jaskowski
authors.forename: E R
authors.initials: ER
authors.lastname: Ashwood
authors.forename: C M
authors.initials: CM
authors.lastname: Litwin
mesh_terms: D000818:Animals; D000910:Antibodies, Heterophile / Q000032:analysis* / Q000276:immunology; D000918:Antibody Specificity; D000956:Antigens, Viral / Q000032:analysis / Q000276:immunology; D015153:Blotting, Western; D002417:Cattle / Q000276:immunology; D003429:Cross Reactions; D004797:Enzyme-Linked Immunosorbent Assay; D005189:False Positive Reactions; D006041:Goats / Q000276:immunology; D015483:HIV Antibodies / Q000032:analysis* / Q000276:immunology; D006679:HIV Seropositivity / Q000175:diagnosis / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D051379:Mice / Q000276:immunology; D008863:Microspheres; D012710:Serum Albumin, Bovine / Q000276:immunology; D012756:Sheep / Q000276:immunology
chemical_list: D000910:Antibodies, Heterophile; D000956:Antigens, Viral; D015483:HIV Antibodies; D012710:Serum Albumin, Bovine