Indeterminate human immunodeficiency virus type 1 western blots: seroconversion risk, specificity of supplemental tests, and an algorithm for evaluation

J Infect Dis. 1991 Oct;164(4):656-64. doi: 10.1093/infdis/164.4.656.

Abstract

The human immunodeficiency virus type 1 (HIV-1) Western blot is indeterminate in 10%-20% of sera reactive by EIA. Eighty-nine individuals with prior repeatedly reactive EIA and indeterminate Western blots were followed prospectively to study the risk of seroconversion and specificity of supplemental tests. Four high-risk cases seroconverted within 10 months after enrollment (seroconversion risk, 4.5%, 95% confidence interval, 1.2%-11.1%). Among cases with p24 bands initially, 4 (18.2%) of 22 high-risk individuals seroconverted compared with 0 of 33 low-risk cases (P = .03). Specificities of HIV-1 culture, serum p24 antigen, polymerase chain reaction, and recombinant ENV 9 EIA were 100%, 100%, 98.6%, and 94.4%, respectively. An expedited evaluation protocol is proposed. Low-risk individuals with nonreactive EIAs upon repeat testing do not need further follow-up; high-risk individuals should be followed serologically for at least 6 months, especially those with p24 bands on Western blot.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS Serodiagnosis*
  • Adolescent
  • Adult
  • Aged
  • Bisexuality
  • Blotting, Western*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • HIV Antibodies / blood*
  • HIV Seropositivity*
  • HIV-1 / immunology*
  • Humans
  • Immunoenzyme Techniques
  • Male
  • Middle Aged
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • Prospective Studies
  • Radioimmunoprecipitation Assay
  • Risk Factors
  • Sexual Partners

Substances

  • HIV Antibodies