Risk Factors for Repeatedly Reactive HIV-1 EIA and Indeterminate Western Blots: A Population-Based Case-Control Study

Connie L. Celum, Robert W. Coombs, Margie Jones, Victory Murphy, Lloyd Fisher, Christopher Grant, Lawrence Corey, Thomas Inui, Mark H. Wener, King K. Holmes

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Objective: Causes of indeterminate results of Western blot testing (IWB) for human immunodeficiency virus (HIV) type 1 include seroconversion, HIV-2 cross-reactivity, and autoimmune disease, but most IWB results remain unexplained. This case-control study assessed risk factors for IWB results, including early HIV infection, other retroviral infection, autoantibodies, and other medical conditions. Design: Prospective study to determine HIV seroconversion rate, with a case-control design to assess other risk factors for IWB. Cases (persons with one or more repeatedly reactive HIV-1 enzyme immunoassay with IWB), their current sexual partners, and controls (persons with negative enzyme immunoassay and Western blot results) were recruited from blood banks, health department and prenatal clinics, and private providers in Washington and Oregon. Results: Of 244 cases enrolled, 206 were followed up for 6 months or longer, and six (3.0%; 95% confidence interval [CI], 0.7% to 5.3%) with recent HIV risk behaviors seroconverted. The Western blot banding patterns differed among groups; cases usually had p17 or p24 bands, while controls and cases’ sexual partners usually had polymerase bands. Conditional logistic regression indicated that independent risk factors for IWB among male cases and controls were a tetanus booster in the past 2 years (odds ratio, 3.2; 95% CI, 1.2 to 8.6) and sexual contact with a prostitute (odds ratio, 3.0; 95% CI, 1.0 to 9.5). Independent risk factors for women were parity (odds ratio, 1.2;95%CI, 1.02 to 1.4) and autoantibodies, either rheumatoid factor or antinuclear antibodies (odds ratio, 2.3; 95% CI, 1.03 to 5.6). No cross-reactivity was detected with HIV-2, human T-lymphotrophic virus type 1, feline immunodeficiency or feline leukemia, or bovine immunodeficiency viruses. Conclusions: Evaluation of persons with reactive HIV-1 enzyme immunoassays and IWB should include an assessment of HIV risk and other possible risk factors, such as alloimmunization (ie, parity or recent immunization) or autoantibodies (ie, antinuclear antibodies and rheumatoid factor). The relationship of IWB among men who reported sex with prostitutes is intriguing and warrants further study.

Original languageEnglish (US)
Pages (from-to)1129-1137
Number of pages9
JournalArchives of Internal Medicine
Volume154
Issue number10
DOIs
StatePublished - May 23 1994
Externally publishedYes

Fingerprint

HIV-1
Case-Control Studies
Western Blotting
Confidence Intervals
Antinuclear Antibodies
Odds Ratio
Immunoenzyme Techniques
HIV
Autoantibodies
Feline Immunodeficiency Virus
Sex Workers
HIV-2
Population
Rheumatoid Factor
Sexual Partners
Parity
Feline Leukemia
Bovine Immunodeficiency Virus
Blood Banks
Tetanus

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Risk Factors for Repeatedly Reactive HIV-1 EIA and Indeterminate Western Blots : A Population-Based Case-Control Study. / Celum, Connie L.; Coombs, Robert W.; Jones, Margie; Murphy, Victory; Fisher, Lloyd; Grant, Christopher; Corey, Lawrence; Inui, Thomas; Wener, Mark H.; Holmes, King K.

In: Archives of Internal Medicine, Vol. 154, No. 10, 23.05.1994, p. 1129-1137.

Research output: Contribution to journalArticle

Celum, CL, Coombs, RW, Jones, M, Murphy, V, Fisher, L, Grant, C, Corey, L, Inui, T, Wener, MH & Holmes, KK 1994, 'Risk Factors for Repeatedly Reactive HIV-1 EIA and Indeterminate Western Blots: A Population-Based Case-Control Study', Archives of Internal Medicine, vol. 154, no. 10, pp. 1129-1137. https://doi.org/10.1001/archinte.1994.00420100115015
Celum, Connie L. ; Coombs, Robert W. ; Jones, Margie ; Murphy, Victory ; Fisher, Lloyd ; Grant, Christopher ; Corey, Lawrence ; Inui, Thomas ; Wener, Mark H. ; Holmes, King K. / Risk Factors for Repeatedly Reactive HIV-1 EIA and Indeterminate Western Blots : A Population-Based Case-Control Study. In: Archives of Internal Medicine. 1994 ; Vol. 154, No. 10. pp. 1129-1137.
@article{dcc3d52a615f4abb9c66494ebfadecc9,
title = "Risk Factors for Repeatedly Reactive HIV-1 EIA and Indeterminate Western Blots: A Population-Based Case-Control Study",
abstract = "Objective: Causes of indeterminate results of Western blot testing (IWB) for human immunodeficiency virus (HIV) type 1 include seroconversion, HIV-2 cross-reactivity, and autoimmune disease, but most IWB results remain unexplained. This case-control study assessed risk factors for IWB results, including early HIV infection, other retroviral infection, autoantibodies, and other medical conditions. Design: Prospective study to determine HIV seroconversion rate, with a case-control design to assess other risk factors for IWB. Cases (persons with one or more repeatedly reactive HIV-1 enzyme immunoassay with IWB), their current sexual partners, and controls (persons with negative enzyme immunoassay and Western blot results) were recruited from blood banks, health department and prenatal clinics, and private providers in Washington and Oregon. Results: Of 244 cases enrolled, 206 were followed up for 6 months or longer, and six (3.0{\%}; 95{\%} confidence interval [CI], 0.7{\%} to 5.3{\%}) with recent HIV risk behaviors seroconverted. The Western blot banding patterns differed among groups; cases usually had p17 or p24 bands, while controls and cases’ sexual partners usually had polymerase bands. Conditional logistic regression indicated that independent risk factors for IWB among male cases and controls were a tetanus booster in the past 2 years (odds ratio, 3.2; 95{\%} CI, 1.2 to 8.6) and sexual contact with a prostitute (odds ratio, 3.0; 95{\%} CI, 1.0 to 9.5). Independent risk factors for women were parity (odds ratio, 1.2;95{\%}CI, 1.02 to 1.4) and autoantibodies, either rheumatoid factor or antinuclear antibodies (odds ratio, 2.3; 95{\%} CI, 1.03 to 5.6). No cross-reactivity was detected with HIV-2, human T-lymphotrophic virus type 1, feline immunodeficiency or feline leukemia, or bovine immunodeficiency viruses. Conclusions: Evaluation of persons with reactive HIV-1 enzyme immunoassays and IWB should include an assessment of HIV risk and other possible risk factors, such as alloimmunization (ie, parity or recent immunization) or autoantibodies (ie, antinuclear antibodies and rheumatoid factor). The relationship of IWB among men who reported sex with prostitutes is intriguing and warrants further study.",
author = "Celum, {Connie L.} and Coombs, {Robert W.} and Margie Jones and Victory Murphy and Lloyd Fisher and Christopher Grant and Lawrence Corey and Thomas Inui and Wener, {Mark H.} and Holmes, {King K.}",
year = "1994",
month = "5",
day = "23",
doi = "10.1001/archinte.1994.00420100115015",
language = "English (US)",
volume = "154",
pages = "1129--1137",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "10",

}

TY - JOUR

T1 - Risk Factors for Repeatedly Reactive HIV-1 EIA and Indeterminate Western Blots

T2 - A Population-Based Case-Control Study

AU - Celum, Connie L.

AU - Coombs, Robert W.

AU - Jones, Margie

AU - Murphy, Victory

AU - Fisher, Lloyd

AU - Grant, Christopher

AU - Corey, Lawrence

AU - Inui, Thomas

AU - Wener, Mark H.

AU - Holmes, King K.

PY - 1994/5/23

Y1 - 1994/5/23

N2 - Objective: Causes of indeterminate results of Western blot testing (IWB) for human immunodeficiency virus (HIV) type 1 include seroconversion, HIV-2 cross-reactivity, and autoimmune disease, but most IWB results remain unexplained. This case-control study assessed risk factors for IWB results, including early HIV infection, other retroviral infection, autoantibodies, and other medical conditions. Design: Prospective study to determine HIV seroconversion rate, with a case-control design to assess other risk factors for IWB. Cases (persons with one or more repeatedly reactive HIV-1 enzyme immunoassay with IWB), their current sexual partners, and controls (persons with negative enzyme immunoassay and Western blot results) were recruited from blood banks, health department and prenatal clinics, and private providers in Washington and Oregon. Results: Of 244 cases enrolled, 206 were followed up for 6 months or longer, and six (3.0%; 95% confidence interval [CI], 0.7% to 5.3%) with recent HIV risk behaviors seroconverted. The Western blot banding patterns differed among groups; cases usually had p17 or p24 bands, while controls and cases’ sexual partners usually had polymerase bands. Conditional logistic regression indicated that independent risk factors for IWB among male cases and controls were a tetanus booster in the past 2 years (odds ratio, 3.2; 95% CI, 1.2 to 8.6) and sexual contact with a prostitute (odds ratio, 3.0; 95% CI, 1.0 to 9.5). Independent risk factors for women were parity (odds ratio, 1.2;95%CI, 1.02 to 1.4) and autoantibodies, either rheumatoid factor or antinuclear antibodies (odds ratio, 2.3; 95% CI, 1.03 to 5.6). No cross-reactivity was detected with HIV-2, human T-lymphotrophic virus type 1, feline immunodeficiency or feline leukemia, or bovine immunodeficiency viruses. Conclusions: Evaluation of persons with reactive HIV-1 enzyme immunoassays and IWB should include an assessment of HIV risk and other possible risk factors, such as alloimmunization (ie, parity or recent immunization) or autoantibodies (ie, antinuclear antibodies and rheumatoid factor). The relationship of IWB among men who reported sex with prostitutes is intriguing and warrants further study.

AB - Objective: Causes of indeterminate results of Western blot testing (IWB) for human immunodeficiency virus (HIV) type 1 include seroconversion, HIV-2 cross-reactivity, and autoimmune disease, but most IWB results remain unexplained. This case-control study assessed risk factors for IWB results, including early HIV infection, other retroviral infection, autoantibodies, and other medical conditions. Design: Prospective study to determine HIV seroconversion rate, with a case-control design to assess other risk factors for IWB. Cases (persons with one or more repeatedly reactive HIV-1 enzyme immunoassay with IWB), their current sexual partners, and controls (persons with negative enzyme immunoassay and Western blot results) were recruited from blood banks, health department and prenatal clinics, and private providers in Washington and Oregon. Results: Of 244 cases enrolled, 206 were followed up for 6 months or longer, and six (3.0%; 95% confidence interval [CI], 0.7% to 5.3%) with recent HIV risk behaviors seroconverted. The Western blot banding patterns differed among groups; cases usually had p17 or p24 bands, while controls and cases’ sexual partners usually had polymerase bands. Conditional logistic regression indicated that independent risk factors for IWB among male cases and controls were a tetanus booster in the past 2 years (odds ratio, 3.2; 95% CI, 1.2 to 8.6) and sexual contact with a prostitute (odds ratio, 3.0; 95% CI, 1.0 to 9.5). Independent risk factors for women were parity (odds ratio, 1.2;95%CI, 1.02 to 1.4) and autoantibodies, either rheumatoid factor or antinuclear antibodies (odds ratio, 2.3; 95% CI, 1.03 to 5.6). No cross-reactivity was detected with HIV-2, human T-lymphotrophic virus type 1, feline immunodeficiency or feline leukemia, or bovine immunodeficiency viruses. Conclusions: Evaluation of persons with reactive HIV-1 enzyme immunoassays and IWB should include an assessment of HIV risk and other possible risk factors, such as alloimmunization (ie, parity or recent immunization) or autoantibodies (ie, antinuclear antibodies and rheumatoid factor). The relationship of IWB among men who reported sex with prostitutes is intriguing and warrants further study.

UR - http://www.scopus.com/inward/record.url?scp=0028228205&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028228205&partnerID=8YFLogxK

U2 - 10.1001/archinte.1994.00420100115015

DO - 10.1001/archinte.1994.00420100115015

M3 - Article

C2 - 7910452

AN - SCOPUS:0028228205

VL - 154

SP - 1129

EP - 1137

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 10

ER -