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Study on the Impact of Cross-Reactive Antibodies Induced by SARS-COV-2 Infection on the False-Positive Rate of HIV
Dong Chen1,2,3,4, Jiayi Zhang1, Feng Zhang3,4
1Wenzhou Central Hospital, The Ding Li Clinical Institute of Wenzhou Medical University, Wenzhou, China.
Purpose:
This study evaluates COVID-19 pandemic phase-specific variations in HIV seroprevalence among volunteer blood donors to elucidate determinants of assay discordance.
Methods:
This retrospective cohort study analyzed 681,232 volunteer blood donations (Wenzhou, 2017-2023) across four pandemic phases: pre-pandemic, containment, surge (Jan-Feb 2023), and stabilization. All specimens underwent dual HIV serological/nucleic acid screening, with reactive cases referred for CDC confirmation.
Results:
Analysis of 681,232 specimens revealed an overall HIV seroreactivity rate of 0.14%, escalating from 0.08% (pre-pandemic) to 0.91% during the Omicron surge phase (Jan-Feb 2023). Among 184 reactive cases in the surge period, 178 (96.7%) showed single-reagent reactivity with predominantly low S/CO ratios (94.9% <5.0), all Western blot (WB)-negative. Significant variance occurred across gender (P=0.043), age (P=0.007), and donation frequency (P=0.001). Indeterminate WB results (n=37) exhibited 5 immunoblot band patterns, with P24 predominance suggesting assay interference.
Conclusion:
SARS-CoV-2 infection induces HIV false-positive seroreactivity, necessitating algorithm optimization in clinical laboratories during pandemic waves to conserve blood resources.
