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What do western blot indeterminate patterns for human immunodeficiency virus mean in EIA-negative blood donors?

J Genesca1, J W Shih, B W Jett

  • 1Department of Transfusion Medicine, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland.

Lancet (London, England)
|October 28, 1989
PubMed

Insights

Western blot indeterminate (WBi) patterns are common in blood donors and recipients and do not indicate human immunodeficiency virus type 1 (HIV-1) infection or transmission. These results suggest WBi results are not reliable indicators of HIV-1 presence.

Area of Science:

  • Immunology
  • Virology
  • Transfusion Medicine

Background:

  • Western blot (WB) indeterminate (WBi) patterns in human immunodeficiency virus type 1 (HIV-1) testing require careful interpretation.
  • Understanding the specificity of WBi patterns is crucial for accurate HIV-1 screening in blood donation and transfusion settings.

Purpose of the Study:

  • To evaluate the specificity of WBi patterns for HIV-1 antibodies.
  • To determine the correlation between WBi patterns and actual HIV-1 infection or transmission.

Main Methods:

  • 100 enzyme immunoassay (EIA) negative donors and their recipients were tested using WB.
  • Serial samples from recipients with WBi patterns were analyzed for reproducibility.
  • Polymerase chain reaction (PCR) was used to detect HIV-1 gag and env sequences.

Main Results:

  • 20% of donors exhibited WBi patterns, predominantly with a p24 band.
  • WBi patterns in recipients were common and not significantly different from control groups receiving WB-negative blood.
  • WBi results showed low reproducibility (35%) in serial testing.
  • No recipients of WBi blood showed evidence of HIV-1 infection, transmission, or antigen positivity.
  • PCR testing for HIV-1 sequences was negative in all participants.

Conclusions:

  • WBi patterns are frequent in randomly selected blood donors and recipients.
  • WBi patterns do not correlate with the presence of HIV-1 infection.
  • WBi patterns do not indicate HIV-1 transmission through blood transfusion.

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