|Antibody tests||Unreliability||False positive||Antibodies/illness|
|Antibodies to HTLV-III/LAV among aboriginal Amazonian indians in Venezuela|| ||Rodriquez L, et al.
| ||It was found that Amazonian Indians who have no contact with individuals outside their tribes and have no AIDS have a 3.3-13.3% HIV WB seropositivity rate depending on the tribe studied|
| ||Lancet 1985;2:1098-1100||1985|
|Seroprevalence rates of human immunodeficiency virus infection at sentinel hospitals in the United States.|| ||St. Louis ME, Rauch KJ, Peterson LR, Anderson JE, Schable CA, Dondero TJ.
| ||Amongst 89,547 anonymously tested blood specimens from 26 US hospital patients at no risk of AIDS, between 0.7% to 21.7% of men and 0-7.8% of women aged 25-44 years were found to be HIV positive (including on WB). It is estimated that approximately 1% of men are gay. Also, at the five hospitals with the highest rates of HIV antibodies, one third of positive tests were in women. The authors excluded even patients with knife and gun shot wounds because such patients do have a slightly increased risk of being HIV positive.|
| ||NEJM 323:213-218, 1990||1990|
|Seroprevalence of Human Immunodeficiency Virus among Childbearing Women.|| ||Hoff R et al.
| ||"The strength of ELISA reactivity...was predictive of positivity on immunoblot [Western Blot] testing. The immunoblot was positive in all 21 specimens with ratios higher than 4.0, in 5 of 7 specimens with ratios of 2.0 to 3.9, and in only 1 of 16 specimens with ratios between 1.0 and 1.9 [this illustrates that the HIV test only became a Black and White test through an arbitrary cutoff value]”|
| ||NEJM. 1988 Mar 3;318(9):525-30.||1988|
|Screening test for HTLV-III (AIDS agent) antibodies: specificity, sensitivity, and applications.|| ||Weiss SH et al.
| ||“We evaluated the validity of the test by determining whether the test could distinguish known patients with AIDS from the normal population and from groups that might pose cross-reactivity problems [but not against actual detection of a virus]...Since the ELISA [antibody test] ratio [indicating the intensity of the antibody reaction] was less than 5.0 in approximately 99% of these controls, serum samples with ratios of 5.0 or greater were defined as positive for HTLV-III [HIV] antibodies”|
| ||JAMA. 1985;253(2):221-5.||1985|
|EVERYBODY REACTS POSITIVE ON THE ELISA TEST FOR HIV|| ||Giraldo Roberto
| ||"The ELISA test is a test for antibodies against what is supposed to be the Human Immunodeficiency Virus or HIV. To run this test, an individual's serum has to be diluted to a ratio of 1:400 with a special specimen diluent. This extraordinary high dilution of the person's serum [400 times] took me by surprise. Most serologic tests that look for the presence of antibodies against germs uses neat serum [undiluted]. For example, the tests that look for antibodies to hepatitis A and B viruses, rubella virus, syphillis, hystoplasma and cryptococus, to mention a few of them, use straight serum [undiluted]. However, to try to prevent false positive reactions some serologic tests use diluted serum; for example this is the case with tests that look for antibodies to measles, varicelia and mumps viruses which use a dilution of 1:16, to cytomegalovirus [CMV] 1:20 and to Epstein-Barr Virus [EBV] 1:10. The obvious questions are: What makes HIV so unique that the test serum nedds to be diluted 400 times?. And what would happen if the individual's serum is not diluted?. To answer these questions I ran an experiment in a medical laboratory in Yorktown Heights, New York. I ran it using the same test kit reagents that are usually used to run the ELISA test in most clinical laboratories worldwide (ABBOT LABORATORIES. Human Immunodeficiency Virus Type 1. FUVAB FffVI EIA. Abbott Laboratories, 66-8805/R5, january 1997:5). I first took samples of blood that, at 1:400 dilution, tested negative for antibodies to HIV. I then ran the exact same serum samples through the test again, but this time without diluting them. Tested straight, they all came positive. Since that time I have run about 100 specimens and have always gotten the same result. I even ran my own blood which, at 1:400 reacts negative. At 1:1 [undiluted] it reacted positive. I should mention that with the exception of my own blood, the patient samples all came from doctors who requested HIV tests. It is therefore likely that most of the blood samples that I tested belonged to individuals at risk for AIDS. What I noticied is that the absorbance values of the specimens that tested negative when diluted [1:400], but positive when undiluted [1:1], had lower values than the samples that, diluted, react positive on both the ELISA and Western Blott tests. This would probably mean that the blood that is negative when diluted but positive when undiluted has a lower level of antibodies than the diluted blood that is doubly positive. It is important to note that the Western Blott antibody test for «HIV» also needs serum to diluted. Although it too has an usually high dilution, here the individual serum is only diluted at the ratio of 1:50 (EPITOPE ORGANON TEKNIKA. Human Immunodeficiency Virus Type 1 (fuV-1) . I-UV-1 Western Blott Kit. PN201-3039 revision number 6)." [+The individuals that react positively only with straight or neat serum would have a smaller amount of antibodies than the ones that continue reacting positively even when the serum is diluted 400 times (88). This possibility has been confirmed by Yugoslavian and Italian researchers : METLAS R, et al. Human Immunodeficiency Virus V3 Peptide-Reactive Antibodies are Present in Normal HIV-Negative Sera. AIDS Research and Human Retroviruses 1999; 15: 671-677.]|
| ||Continuum Midwinter 1998/9||1998|
|False Positive Tests for HTLV-III Antibodies in Alcoholic Patients with Hepatitis.|| ||Mendenhall, C. L., Roselle, G. A., Grossman, C. J., Rouster, S. D. & Weener, R. E.,
| ||another group with chronic liver disease, alcoholics, are known to have both false positive antibody tests and immune deficiency|
| ||NEJM, 1986. 314:921-922.||1986|
|Multiple false-positive serologic tests for HIV, HTLV-1, and hepatitis C following influenza vaccination|| ||Mac Kenzie, W.R., et al.,
| ||7 out of 10 blood donors treated with an influenza virus vaccine in 1991 became HIV ELISA-positive. Each of these proved to be false-positives upon confirmation with a Western blot.|
| ||JAMA 268, 1015-1017, 1992||1992|
|False-positive serologic tests for human T-cell lymphotropic virus type I among blood donors following influenza vaccination, 1992|| ||No author
| ||"From October 31 through December 15, 1991, 10 blood donors to the American Red Cross Blood Services, Badger Region (ARCBS), were found to have false-positive screening enzyme-linked immunosorbent assays (ELISAs) for antibodies to ... human immunodeficiency virus type 1 (HIV-1)... An investigation ... indicated that the risk for false-positive reactivity was associated with antecedent receipt of influenza vaccine formulated for the 1991-92 season. In March 1992, the ARCBS began use of newly available ELISAs for anti-HIV... From January 1 through October 13, 1992, the ARCBS identified 19 blood donors with repeatedly reactive ELISAs for HTLV-I. However, from October 14 through November 10, 15 false-positive ELISAs for HTLV-I were reported by the ARCBS to the WDOH. As a result of this increase, the ARCBS conducted a case-control study to assess the relation between influenza vaccination and testing positive for HTLV-I."|
| ||MMWR Morb Mortal Wkly Rep 1993 Mar 12;42(9):173-5||1993|
|Leprosy as cause of false-positive results in serological assays for the detection of antibodies to HIV-1|| ||Andrade VL, Avelleira JC, Marques A, Vianna FR, Schechter M.
| ||No abstract / Pubmed|
| ||Int J Lepr Other Mycobact Dis 1991 Mar;59(1):125-6||1991|
|Infection with HIV-1 and HTLV among leprosy patients and contacts: Correlation between HIV-1 cross-ractivity and antibodies to lipoarabinomannan,|| ||Kashala, O. Marlink, R. Ilunga, M. Diese, M. Gormus, B. Xu, K. Mukeba, P. Kasongo, K. & Essex, M.
| ||This study in central Africa reported that the microbes responsible for tuberculosis and leprosy were so prevalent that over 70% of the HIV-positive test results were false. The cross-reactivity was found to be caused by antibodies directed against two major carbohydrate-containing M. leprae antigens--phenolic glycolipid I and especially lipoarabinomannan, an arabinose-containing lipopolysaccharide which is also present in M. tuberculosis and other mycobacteria. This prompted Essex and his collaborators to warn that ELISA results should be "interpreted with caution" in areas where HIV and TB were co-endemic. Indeed, they speculated that existing antibody tests "may not be sufficient for HIV diagnosis" in settings where TB and related diseases are commonplace.|
| ||J Infect Dis , 1994; 169: 296-304||1994|
|Interpretation of antibodies reacting solely with human retroviral core proteins.|| ||Ranki A, Johansson E, Krohn K.
| ||“we found crossreacting antibodies...to HIV-1 in patients with multiple sclerosis. Among 150 healthy Finnish persons, 1 (a woman) had antibodies to p24 and p55 of HIV-1. Some patients with multiple sclerosis, cutaneous T-cell lymphoma, or dermatologic disorders had antibodies that also reacted with the viral proteins of an HIV-2 isolate”|
| ||NEJM. 1988;318:448-9.||1988|
|Possible nonspecific associations between malaria and HTLV-III/LAV.|| ||Biggar, R. J.
| ||HIV researchers accept that "antilymphocyte, antinuclear and other autoantibodies" give rise to false positive HIV antibody tests|
| ||NEJM 315:457. 1986.||1986|