Indeterminate human immunodeficiency virus type 1 western blots: Seroconversion risk, specificity of supplemental tests, and an algorithm for evaluation

Connie L. Celum, Robert W. Coombs, William Lafferty, Thomas S. Inui, Pamela H. Louie, Carol A. Gates, Bruce J. McCreedy, Richard Egan, Thomas Grove, Steve Alexander, Thomas Koepsell, Noel Weiss, Lloyd Fisher, Lawrence Corey, King K. Holmes

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

The human immunodeficiency virus type 1 (HIV-1) Western blot is indeterminate in 10%-20% of sera reactive by EIA. Eighty-nine individuals with prior repeatedly reactive EIA and indeterminate Western blots were followed prospectively to study the risk of seroconversion and specificity of supplemental tests. Four high-risk cases seroconverted within 10 months after enrollment (seroconversion risk, 4.5%, 95% confidence interval, 1.2%-11.1%). Among cases with p24 bands initially, 4 (18.2%) of 22 high-risk individuals seroconverted compared with 0 of 33 low-risk cases (P = .03). Specificities of HIV-1 culture, serum p24 antigen, polymerase chain reaction, and recombinant ENV 9 EIA were 100%, 100%, 98.6%, and 94.4%, respectively. An expedited evaluation protocol is proposed. Low-risk individuals with nonreactive EIAs upon repeat testing do not need further follow-up; high-risk individuals should be followed serologically for at least 6 months, especially those with p24 bands on Western blot.

Original languageEnglish (US)
Pages (from-to)656-664
Number of pages9
JournalJournal of Infectious Diseases
Volume164
Issue number4
DOIs
StatePublished - Oct 1991
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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