Dissident AIDS Database

Antibody testsUnreliabilityFalse positivePregnancy
Evaluation of atypical human immunodeficiency immunoblot reactivity in blood donors.
 Dock NL et al.
  "Undefined autoimmune phenomena [such as multiple pregnancies], bovine exposure, or cross-reactivity with other human retroviruses could be possible causes for consistently reactive HIV immunologic assays”
  Transfusion. 1988;28:4121988
Ng V. Serological diagnosis with recombinant peptides/proteins
 1
  “Re-read with pregnant women in mind.”
  Clin Chem. 1991;37(10):1667-8.1991
Serologic testing for human immunodeficiency virus antibodies.
 Steckelberg JM, Cockerill F.
  "One notable association with false positive ELISA reactivity in some commercial preparations has been patients with anti-HLA-DR4 antibodies, most often multiparous [having experienced one or more births] women"
  Mayo Clin Proc. 1988;63:373-9.1988
Epidemiological Fact Sheet
 UNAIDS. Zimbabwe.
  HIV incidence during antenatal and/or post-partum periods in Africa exceeds what can be expected solely from sexual transmission
  Geneva: WHO, 2000. [2000 update].2000
Manufacturer's notice
 Abbott Laboratories
  The manufacturer of the HIV-antibody test that was used in the surveys specifically warns that, “non-specific reactions may be seen in samples from some people who, for example, due to prior pregnancy...have antibodies to the human cells or media in which HIV-1 is grown for manufacture of the EIA.”
  Human Immunodeficiency virus type 1 HIVAB HIV-1 EIA. Abbott Park, IL: Abbott Laboratories, 19971997
Nelson Mandela Foundation/HSRC Study of HIV/AIDS: South African National HIV Prevalence, Behavioral Risks and Mass Media.
 Nelson Mandela Foundation/HSRC
  [Comment from Roberto Giraldo] “HIV prevalence derived from antenatal data: This study calculated the HIV prevalence among women who reported being pregnant in the 12 months before the study (n=244) and found that 24% (CI: 15.8-34.8%) were HIV positive, a finding similar to the Department of Health's survey of clinics, which found 24.8%” (page 59). However, 24% ELISA reactivity in pregnant women doubles the national average of 11.4% found for all South Africans and that of 12.8% found for women in this study. The high percentage of reactivity on ELISA tests found in pregnant women by both this study and the Department of Health's surveys can be explained due to the fact that pregnancy and multiparity are known risk factors for reacting positively on antibody tests “for HIV” .
  Household Survey 20022002
Epidemiological fact sheet
 UNAIDS. Kenya.
  HIV incidence during antenatal and/or post-partum periods in Africa exceeds what can be expected solely from sexual transmission
  Geneva: WHO, 2000 [2000 update].2000
Seroincidence of HIV-1 infection in African women of reproductive age: a prospective cohort study in Kigali, Rwanda, 1988-1992.
 Leroy V et al.
  HIV incidence during antenatal and/or post-partum periods in Africa exceeds what can be expected solely from sexual transmission
  AIDS 1994; 8: 683-686.1994
Epidemiological fact sheet
 UNAIDS. Rwanda.
  HIV incidence during antenatal and/or post-partum periods in Africa exceeds what can be expected solely from sexual transmission
  Geneva: WHO, 2000. [2000 update].2000
Apparent vertical transmission of human immunodeficiency virus type 1 by breast-feeding in Zambia.
 Hira SK et al.
  HIV incidence during antenatal and/or post-partum periods in Africa exceeds what can be expected solely from sexual transmission
  J Pediatr 1990; 117: 421-424.1990
Laboratory diagnosis of human immunodeficiency virus infection.
 Proffitt MR, Yen-Lieberman B.
  "Notable causes of false-positive reactions have been anti-HLA-DR antibodies that sometimes occur in multiparous women"
  Inf Dis Clin North Am. 1993;7:203-19.1993
Risk factors for repeatedly reactive HIV-1 EIA and indeterminate Western blots: a population-based case control study.
 Celum CL et al.
  “potential causes of indeterminate Western blots for HIV-1...included...HLA antibody cross-reacticity, and current pregnancy...All but one of the cases who demonstrated anti-class I HLA reactivity were multiparous women [pregnant more than once]”
  Arch Int Med. 1994 May 23;154:1129-37.1994
HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission.
 Gisselquist D, Rothenberg R, Potterat J, Drucker EM.
  "We reported unexplained high rates of HIV incidence in African women during antenatal care and postpartum: In five studies of incidence in HIV-negative cohorts (Buve A, Lagarde E, Carael M, et al. Interpreting sexual behaviour data: validity issues in the multicentre study on factors determining the differential spread of HIV in four African cities. AIDS 2001;15(Suppl 4): S117–S126, Taha TE, Hoover DR, Dallabetta GA, et al. Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS 1998;12:1699–1706, Taha TE, Dallabetta GA, Hoover DR, et al. Trends of HIV-1 and sexually transmitted diseases among pregnant and postpartum women in urban Malawi. AIDS 1998;12:197–203, Olayinka BA, Obi CL. Symptomatic HIV-infection in infants according to serostatus of mothers during pregnancy. East Afr Med J 1999;76:566–570, Qolohle DC, Hoosen AA, Moodley J, Smith AN, Mlisana KP. Serological screening for sexually transmitted infections in pregnancy; is there any value in re-screening for HIV and syphilis at the time of delivery? Genitourin Med 1995;71:65 –67, Datta P, Embree J, Kreiss JK, et al. Mother-to-child transmission of human immunodeficiency virus type 1: report from Nairobi study. J Infect Dis 1994;170:1134–1140) -in Kenya, Malawi, Rwanda, South Africa and Zimbabwe- from first antenatal visit to delivery and in the months after delivery, HIV incidence ranged from 6.2 to 21 per 100 person years. After allowing for possible sexual transmission [assuming (a) the proportion of women with HIV-positive partners is equal to the percentage of women who were HIV-positive in the sample from which the cohort was drawn and (b) HIV transmission from seropositive partners of 10 per 100 person years, which is the average from five studies of African women with HIV-positive partners continuing unprotected sex], these studies show unexplained incidence of 4–19 per 100 person years. In Malawi, HIV incidence during the antenatal and postpartum periods combined fell from 21 per 100 person years in 1990 to 1.1 per 100 in 1994–1995, while HIV prevalence—and presumably risk for sexual transmission—increased. The high prevalence of HIV reactivity in women during antenatal or post-partum periods “suggests that something more than simply heterosexual transmission is involved... Whatever happens during one or two pregnancies and post-partum periods – whether iatrogenic or sexual or something else – may largely account for observed high levels of HIV among low risk women in at least some African communities”
  Int J STD AIDS 2002;13:657–666.2002