Determination of the etiology of seroreversals in HIV testing by antibody fingerprinting

Fifteen sets of seroreversal serum samples (i.e., an initial specimen confirmed as anti-human immunodeficiency virus, HIV, positive and a 2-4-week follow-up specimen that is anti-HIV negative) were identified from 711,684 military members tested by the U.S. Army HIV screening program from January 1990 to May 1991. We utilized the Miragen Antibody Fingerprinting Assay to determine what proportion of these seroreversals was caused by different or discordant patient samples as opposed to laboratory testing errors. Forty-two percent of these seroreversals demonstrated substantially discordant immunoblot strips representing serum samples from different patients. We recommend utilization of this antibody fingerprinting assay to help determine the etiology of HIV seroreversal specimens.