title: False-positive human immunodeficiency virus enzyme immunoassay results in pregnant women.
abstract: OBJECTIVE
  Examine whether false-positive HIV enzyme immunoassay (EIA) test results occur more frequently among pregnant women than among women who are not pregnant and men (others).
  
  
  METHODS
  To obtain a large number of pregnant women and others tested for HIV, we identified specimens tested at a national laboratory using Genetic Systems HIV-1/HIV-2 Plus O EIA from July 2007 to June 2008.
  
  
  METHODS
  Specimens with EIA repeatedly reactive and Western blot-negative or indeterminate results were considered EIA false-positive. We compared the false-positive rate among uninfected pregnant women and others, adjusting for HIV prevalence. Among all reactive EIAs, we evaluated the proportion of false-positives, positive predictive value (PPV), and Western blot bands among indeterminates, by pregnancy status.
  
  
  RESULTS
  HIV prevalence was 0.06% among 921,438 pregnant women and 1.34% among 1,103,961 others. The false-positive rate was lower for pregnant women than others (0.14% vs. 0.21%, odds ratio 0.65 [95% confidence interval 0.61, 0.70]). Pregnant women with reactive EIAs were more likely than others (p<0.01) to have Western blot-negative (52.9% vs. 9.8%) and indeterminate results (17.0% vs. 3.7%) and lower PPV (30% vs. 87%). The p24 band was detected more often among pregnant women (p<0.01).
  
  
  CONCLUSIONS
  False-positive HIV EIA results were rare and occurred less frequently among pregnant women than others. Pregnant women with reactive EIAs were more likely to have negative and indeterminate Western blot results due to lower HIV prevalence and higher p24 reactivity, respectively. Indeterminate results may complicate clinical management during pregnancy. Alternative methods are needed to rule out infection in persons with reactive EIAs from low prevalence populations.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Laura G
authors.initials: LG
authors.lastname: Wesolowski
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Delaney
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Lampe
authors.forename: Steven R
authors.initials: SR
authors.lastname: Nesheim
mesh_terms: D000328:Adult; D015153:Blotting, Western; D005189:False Positive Reactions; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods* / Q000592:standards; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000821:virology*; D015995:Prevalence; D055815:Young Adult