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Updated: Aug 6, 2026
Amplifying and Quantifying HIV-1 RNA in HIV Infected Individuals with Viral Loads Below the Limit of Detection by Standard Clinical Assays
Published on: September 26, 2011
Detection of HIV-1 RNA in two consecutive blood donations screened negative for HIV antibodies
N Burin des Roziers1, J Coste, A Courouce
1Etablissement de Transfusion Sanguine de Languedoc-Roussillon, Nîmes, France.
Background And Objectives:
An unusual serological pattern of HIV-1 seroconversion in a blood donor is described. The seroconversion panel was used to investigate the sensitivity of existing screening assays.
Materials And Methods:
A volunteer blood donor who had given blood 79 times was diagnosed anti-HIV-1-antibody-positive. The heteroduplex mobility assay identified a subtype B HIV-1 strain. The frozen plasmas from the last four blood donations had been kept at -30 degrees C. They were thawed and aliquoted for subsequent testing.
Results:
The last two blood donations contained HIV-1 RNA, 2,800 copies/ml (October 26) and 170 copies/ml (November 23). Weak anti-p24 antibodies were detected by Western blot in the October 26 sample, and a clear p24 reactivity along with a faint gp160 reactivity was observed on November 23. HIV p24 antigen was undetectable in both samples. Out of 13 screening assays, only 6 gave positive results on the November sample and 7 negative results which were obtained by 1 competitive enzyme immunoassay (EIA) and 6 of the 9 sandwich EIAs.
Conclusion:
Most sandwich EIAs gave prolonged false-negative results in the present case. p24 antigen testing was negative and would not have reduced the risk of HIV transmission.
