High rate of missed HIV infections in individuals with indeterminate or negative HIV western blots based on current HIV testing algorithm in China

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 indetermin...

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Bibliographic Details
Published in:Journal of medical virology 2016-08, Vol.88 (8), p.1462-1466
Main Authors: Liu, Man-Qing, Zhu, Ze-Rong, Kong, Wen-Hua, Tang, Li, Peng, Jin-Song, Wang, Xia, Xu, Jun, Schilling, Robert F., Cai, Thomas, Zhou, Wang
Format: Article
Language:English
Subjects:
Adult
AIDS Serodiagnosis
Algorithms
Blotting, Western
China
China - epidemiology
Delayed Diagnosis
Enzyme-Linked Immunosorbent Assay - standards
enzyme-linked immunosorbent assays (ELISA)
False Negative Reactions
Female
HIV
HIV Antibodies - blood
HIV Infections - diagnosis
HIV Infections - epidemiology
HIV Infections - immunology
HIV Infections - virology
HIV-1 - genetics
HIV-1 - immunology
HIV-1 nucleic acid test (NAT)
HIV-2 - genetics
HIV-2 - immunology
Human immunodeficiency virus
Human immunodeficiency virus 1
Humans
Immunoassay
Male
Medical tests
Middle Aged
Polymerase Chain Reaction
Retrospective Studies
RNA, Viral - blood
RNA, Viral - genetics
RNA, Viral - isolation & purification
Serologic Tests - methods
Serologic Tests - standards
Virology
western blot (WB)
Young Adult
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Summary: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.
ISSN:0146-6615
1096-9071
DOI:10.1002/jmv.24490