title: High rate of missed HIV infections in individuals with indeterminate or negative HIV western blots based on current HIV testing algorithm in China.
abstract: It remains unclear if China's current HIV antibody testing algorithm misses a substantial number of HIV infected individuals. Of 196 specimens with indeterminate or negative results on HIV western blot (WB) retrospectively examined by HIV-1 nucleic acid test (NAT), 67.57% (75/111) of indeterminate WB samples, and 16.47% (14/85) of negative WB samples were identified as NAT positive. HIV-1 loads in negative WB samples were significantly higher than those in indeterminate WB samples. Notably, 86.67% (13/15) of samples with negative WB and double positive immunoassay results were NAT positive. The rate of HIV-1 infections missed by China's current HIV testing algorithm is unacceptably high. Thus, China should consider using NAT or integrating fourth generation ELISA into current only antibodies-based HIV confirmation. J. Med. Virol. 88:1462-1466, 2016. © 2016 Wiley Periodicals, Inc.
authors: Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors: Man-Qing
authors: MQ
authors: Liu
authors: Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors: Ze-Rong
authors: ZR
authors: Zhu
authors: Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors: Wen-Hua
authors: WH
authors: Kong
authors: Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors: Li
authors: L
authors: Tang
authors: Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors: Jin-Song
authors: JS
authors: Peng
authors: Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors: Xia
authors: X
authors: Wang
authors: Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors: Jun
authors: J
authors: Xu
authors: Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, California.
authors: Robert F
authors: RF
authors: Schilling
authors: AIDS Care of China, Nanning, Guangxi, China.
authors: Thomas
authors: T
authors: Cai
authors: Department of Virology, Wuhan Centers for Disease Prevention and Control, Wuhan, China.
authors: Wang
authors: W
authors: Zhou
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D000465:Algorithms; D015153:Blotting, Western; D002681:China / Q000453:epidemiology; D057210:Delayed Diagnosis; D004797:Enzyme-Linked Immunosorbent Assay / Q000592:standards; D005188:False Negative Reactions; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D015498:HIV-2 / Q000235:genetics / Q000276:immunology; D006801:Humans; D007118:Immunoassay; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood / Q000235:genetics / Q000302:isolation & purification; D012189:Retrospective Studies; D012698:Serologic Tests / Q000379:methods / Q000592:standards; D055815:Young Adult
chemical_list: D015483:HIV Antibodies; D012367:RNA, Viral
keywords: China; HIV-1 nucleic acid test (NAT); enzyme-linked immunosorbent assays (ELISA); western blot (WB)