Human immunodeficiency virus (HIV) infection screening in a dialysis unit

Human immunodeficiency virus (HIV) screening is a routine for long-term hemodialysis patients because of a high risk for infection. Enzyme-immunoassay (EIA) is a simple tool for screening HIV, but clinically false-positive EIA is a frequent result. Other tests such as Western blot analysis (WB) and HIV DNA and RNA by polymerase chain reaction have better specificity and sensitivity, but they cannot be accessible in many dialysis units.

Four hundred and four patients with end stage renal disease on long-term hemodialysis were screened with EIA for HIV antibodies. Repeated EIA was performed if the first test was positive result. WB was used as the confirmatory test.

Two persons initially showed a positive EIA pattern among the 404 patients, but nobody had positive WB test result later.

The ratio of false-positive EIA results for screening HIV is relatively high in long-term hemodialysis patients. Further tests should be employed to confirm the diagnosis.