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ANTIBODIES ARE THEY ANYWAY?
Known to Cause False Positive HIV Antibody Test Results
establishment has managed to convince many people that the HIV
antibody tests (ELISA, IFA and Western blot) are "99.5%
accurate". In this article Christine Johnson from HEAL
Los Angeles, lists conditions documented in the scientific
literature known to cause positives on these tests, and gives
It is expected
that this list will generate much discussion and dissension.
For the time being, a few clarifications should be made at the
something is on the list doesn't mean that it will definitely,
or even probably, cause a false-positive. It depends on what
antibodies the individual carries; as well as the
characteristics of each particular test kit.
some, but not all, people who have had blood transfusions,
prior pregnancies or an organ transplant will make HLA
antibodies. And some, but not all, test kits (both ELISA and
Western blot) will be contaminated with HLA antigens to which
these antibodies can react. Only if these two conditions
coincide might you get a false-positive due to HLA
Some things are
more likely than others to cause false-positives. And some
things that we aren't aware of yet, but which may be
documented in the future, may cause false-positives. Some of
the factors on the list have been documented only for ELISA,
some for both ELISA and Western blot (WB).
Some people may
be eager to argue that if a factor is only known to cause
false-positives on ELISA, this problem won't be carried over
to the WB, so everything should be OK. But remember, a WB is
positive by virtue of accumulating enough individual positive
bands to add up to the total required by whatever criteria you
use to interpret it (39) So the more exposures a person has
had to foreign antigens, proteins and infectious agents, the
more various antibodies he or she will have in their system,
and the more likely it is that there will be several
cross-reacting antibodies, enough to make the WB positive.
It is to be
noted that all AIDS risk groups (and Africans as well), but
not the general US or Western European population, have this
problem in common: they have been exposed to a plethora of
foreign antigens and proteins. This is why people in the
AIDS "risk groups" tend to have positive WBs (i.e.,
to be considered "HIV-infected") and people in the
general population don't. However, even people in the low-risk
populations may have false-positive Western blots for poorly
false-positives to every single HIV protein have been
documented (36), how do you know the positive WB bands
represent the various proteins to HIV, or just a collection of
false-positive bands reacting to several different non-HIV
Factors Known to Cause
False-Positive HIV Antibody Test Results
Anti-carbohydrate antibodies (52, 19, 13)
Naturally-occurring antibodies (5, 19)
Passive immunization: receipt of gamma globulin
or immune globulin (as prophylaxis against infection which
contains antibodies)(18, 26, 60, 4, 22, 42, 43, 13)
Leprosy (2, 25)
Mycobacterium avium (25)
Systemic lupus erythematosus (15, 23)
Renal (kidney) failure (48, 23, 13)
Hemodialysis/renal failure (56, 16, 41, 10, 49)
Alpha interferon therapy in hemodialysis
Flu vaccination (30, 11, 3, 20, 13, 43)
Herpes simplex I (27)
Herpes simplex II (11)
Upper respiratory tract infection (cold or
Recent viral infection or exposure to viral
Pregnancy in multiparous women (58, 53, 13, 43,
Malaria (6, 12)
High levels of circulating immune complexes (6,
Hypergammaglobulinemia (high levels of
antibodies) (40, 33)
False positives on other tests, including RPR
(rapid plasma reagent) test for syphilis (17, 48, 33, 10, 49)
Rheumatoid arthritis (36)
Hepatitis B vaccination (28, 21, 40, 43)
Tetanus vaccination (40)
Organ transplantation (1, 36)
Renal transplantation (35, 9, 48, 13, 56)
Anti-lymphocyte antibodies (56, 31)
Anti-collagen antibodies (found in gay men,
haemophiliacs, Africans of both sexes and people with
Serum-positive for rheumatoid factor,
antinuclear antibody (both found in rheumatoid arthritis and
other autoantibodies)(14, 62, 53)
Autoimmune diseases (44, 29, 10, 40, 49, 43):
Systemic lupus erythematosus, scleroderma, connective tissue
Acute viral infections, DNA viral infections
(59, 48, 43, 53, 40, 13)
Malignant neoplasms (cancers)(40)
Alcoholic hepatitis/alcoholic liver disease (32,
48, 40,10,13, 49, 43, 53)
Primary sclerosing cholangitis (48, 53)
"Sticky" blood (in Africans) (38, 34,
Antibodies with a high affinity for polystyrene
(used in the test kits)(62, 40, 3)
Blood transfusions, multiple blood transfusions
(63, 36,13, 49, 43, 41)
Multiple myeloma (10, 43, 53)
HLA antibodies (to Class I and II leukocyte
antigens)(7, 46, 63, 48, 10, 13, 49, 43, 53)
Anti-smooth muscle antibody (48)
Anti-parietal cell antibody (48)
Anti-hepatitis A IgM (antibody)(48)
Anti-Hbc IgM (48)
Administration of human immunoglobulin
preparations pooled before 1985 (10)
Haemophilia (10, 49)
Haematologic malignant disorders/lymphoma (43,
53, 9, 48, 13)
Primary biliary cirrhosis (43, 53, 13, 48)
Stevens-Johnson syndrome9, (48, 13)
Q-fever with associated hepatitis (61)
Heat-treated specimens (51, 57, 24, 49, 48)
Lipemic serum (blood with high levels of fat or
Haemolyzed serum (blood where haemoglobin is
separated from the red cells)(49)
Hyperbilirubinemia (10, 13)
Globulins produced during polyclonal
gammopathies (which are seen in AIDS risk groups)(10, 13, 48)
Healthy individuals as a result of
poorly-understood cross-reactions (10)
Normal human ribonucleoproteins (48,13)
Other retroviruses (8, 55, 14, 48, 13)
Anti-mitochondrial antibodies (48, 13)
Anti-nuclear antibodies (48, 13, 53)
Anti-microsomal antibodies (34)
T-cell leukocyte antigen antibodies (48, 13)
Proteins on the filter paper (13)
Epstein-Barr virus (37)
Visceral leishmaniasis (45)
Receptive anal sex (39, 64)
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