Avoiding false positive HIV results on life assurance proposers: the necessity for follow-up

The serological reaction to HIV infection is almost invariably a dynamic progression towards strong reactivity to a wide range of viral antigens. Serological diagnosis should therefore be based either on the presence of this wide range in a single specimen or on the demonstration of increasing activity between two specimens collected at an interval of two or more weeks and tested in parallel. When a specimen is reactive a second should in any case be collected to check the identity of the first. These precepts are sometimes being ignored, especially in non-clinical testing, e.g., for purpose of life assurance. Two recent cases in which there were false but unchanging enzyme immunoassay and Western blot reactions that might have been interpreted as positive illustrate the potential for error.