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Analysis of false positive HIV-1 serologic testing in Kenya
T L Kuhls1, P G Nishanian, J D Cherry
1Department of Pediatrics, UCLA School of Medicine.
Diagnostic Microbiology and Infectious Disease
|March 1, 1988
Summary
False positive human immunodeficiency virus type 1 (HIV-1) antibody tests were common in East African women. HIV-1 enzyme immunoassays (EIAs) showed low specificity in Kenya, requiring cautious interpretation of seroprevalence data.
Area of Science:
- Immunology
- Epidemiology
- Virology
Background:
- Human immunodeficiency virus type 1 (HIV-1) seroprevalence studies in East Africa are crucial for understanding the epidemic.
- Enzyme immunoassays (EIAs) are common screening tools for HIV-1 antibodies.
- Previous studies have not thoroughly evaluated EIA specificity in diverse East African populations.
Purpose of the Study:
- To assess the specificity of HIV-1 antibody detection using enzyme immunoassay (EIA) in Kenyan populations.
- To investigate the occurrence of false positive HIV-1 EIA results in women and children from Nairobi and Embu District.
- To determine if other viral infections or human leukocyte antigen (HLA) phenotypes contribute to false positive EIA results.
Main Methods:
- Sera from mothers and children in Nairobi (1976) and adults and children in Embu District (1984-1985) were analyzed.
- Western blot analysis was used to confirm HIV-1 seropositivity.
- Enzyme immunoassay (EIA) was employed for initial antibody screening, with further analysis for simian T lymphotropic virus type III (STLV-IIIAGM)/human T lymphotropic virus type IV (HTLV-IV) and HLA-DR4/HLA-DQw3 phenotypes.
Main Results:
- No confirmed HIV-1 seropositivity was detected by western blot in either study group.
- False positive HIV-1 EIA results were observed in 7% of Nairobi mothers and 10% of Embu adult females.
- Less than 1% seroreactivity was found in adult males and children, and false positives were not linked to STLV-IIIAGM/HTLV-IV or specific HLA phenotypes.
Conclusions:
- Enzyme immunoassays (EIAs) for human immunodeficiency virus type 1 (HIV-1) antibodies frequently yield false positive results in East Africa.
- The specificity of HIV-1 EIAs appears reduced in certain populations, particularly adult females in Kenya.
- Seroprevalence data from rural African settings should be interpreted with caution due to potential decreased EIA specificity, impacting epidemiological assessments.