http://www.aliveandwell.org/index.php?page=reasons

 

Visit our new Online Store
where you can purchase Books, Videos,
Great New T-Shirts, and Information Packs

 

 

 

Translate this site with babel fish

 

Deutsch Españole Français Italiano Português  


Why Question AIDS?

60 Reasons to Question a Positive HIV Test

Another Look at AIDS Drugs

AIDS Myth Busters

Life After HIV
Personal Survival Stories

Alive & Grateful
Letters, survival stories and thanks from around the globe

What About Africa

Before You Take a Test

Before You Take or Receive Treatment

Q&A With Christine
(FAQ)

Featured Articles

AIDS War Targets Women & Children

Alive & Well in Mexico

Alive & Well in Africa

Foo Fighters Benefit

AIDS Dissidents Meet San Fransisco Mayor Willie Brown

San Fransisco Dissident Campaign
Taking it to the Streets

Wall of Shame

Past Events

Special Thanks

Factors Known to Cause
False Positive HIV Antibody Test Results

  1. Anti-carbohydrate antibodies 52,19,13
  2. Naturally-occurring antibodies 5,19
  3. Passive immunization: receipt of gamma globulin or immune globulin (as prophylaxis against infection which contains antibodies) 18, 26, 60, 4, 22, 42, 43, 13
  4. Leprosy 2, 25
  5. Tuberculosis 25
  6. Mycobacterium avium 25
  7. Systemic lupus erythematosus 15, 23
  8. Renal (kidney) failure 48, 23, 13
  9. Hemodialysis/renal failure 56, 16, 41, 10, 49
  10. Alpha interferon therapy in hemodialysis patients 54
  11. Flu 36
  12. Flu vaccination 30, 11, 3, 20, 13, 43
  13. Herpes simplex I 27
  14. Herpes simplex II 11
  15. Upper respiratory tract infection (cold or flu) 11
  16. Recent viral infection or exposure to viral vaccines 11
  17. Pregnancy in multiparous women 58, 53, 13, 43, 36
  18. Malaria 6, 12
  19. High levels of circulating immune complexes 6, 33
  20. Hypergammaglobulinemia (high levels of antibodies) 40, 33
  21. False positives on other tests, including RPR (rapid plasma reagent) test for syphilis 17, 48, 33, 10, 49
  22. Rheumatoid arthritis 36
  23. Hepatitis B vaccination 28, 21, 40, 43
  24. Tetanus vaccination 40
  25. Organ transplantation 1, 36
  26. Renal transplantation 35, 9, 48, 13, 56
  27. Anti-lymphocyte antibodies 56, 31
  28. Anti-collagen antibodies (found in gay men, haemophiliacs, Africans of both sexes and people with leprosy) 31
  29. Serum-positive for rheumatoid factor, antinuclear antibody (both found in rheumatoid arthritis and other autoantibodies) 14, 62, 53
  30. Autoimmune diseases 44, 29, 1O, 40, 49, 43
  31. Systemic lupus erythematosus, scleroderma, connective tissue disease, dermatomyositis Acute viral infections, DNA viral infections 59, 48, 43, 53, 40, 13
  32. Malignant neoplasms (cancers) 40
  33. Alcoholic hepatitis/alcoholic liver disease 32, 48, 40, 10, 13, 49, 43, 53
  34. Primary sclerosing cholangitis 48, 53
  35. Hepatitis 54
  36. "Sticky" blood (in Africans) 38, 34, 40
  37. Antibodies with a high affinity for polystyrene (used in the test kits) 62, 40, 3
  38. Blood transfusions, multiple blood transfusions 63, 36, 13, 49, 43, 41
  39. Multiple myeloma 10, 43, 53
  40. HLA antibodies (to Class I and II leukocyte antigens) 7, 46, 63, 48, 10, 13, 49, 43, 53
  41. Anti-smooth muscle antibody 48
  42. Anti-parietal cell antibody 48
  43. Anti-hepatitis A IgM (antibody) 48
  44. Anti-Hbc IgM 48
  45. Administration of human immunoglobulin preparations pooled before 1985 10
  46. Haemophilia 10, 49
  47. Haematologic malignant disorders/lymphoma 43, 53, 9, 48, 13
  48. Primary biliary cirrhosis 43, 53, 13, 48
  49. Stevens-Johnson syndrome 9, 48, 13
  50. Q-fever with associated hepatitis 61
  51. Heat-treated specimens 51, 57, 24, 49, 48
  52. Lipemic serum (blood with high levels of fat or lipids) 49
  53. Haemolyzed serum (blood where haemoglobin is separated from the red cells) 49
  54. Hyperbilirubinemia 10, 13
  55. Globulins produced during polyclonal gammopathies (which are seen in AIDS risk groups) 10, 13, 48
  56. Healthy individuals as a result of poorly-understood cross-reactions 10
  57. Normal human ribonucleoproteins 48, 13
  58. Other retroviruses 8, 55, 14, 48, 13
  59. Anti-mitochondrial antibodies 48, 13
  60. Anti-nuclear antibodies 48, 13, 53
  61. Anti-microsomal antibodies 34
  62. T-cell leukocyte antigen antibodies 48, 13
  63. Proteins on the filter paper 13
  64. Epstein-Barr virus 37
  65. Visceral leishmaniasis 45
  66. Receptive anal sex 39, 64

Christine Johnson, a researcher and author, compiled this list of conditions documented in the scientific literature to cause positives on HIV tests, and provides references for each condition.

Christine notes:

"Just because something is on this 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.

For instance, 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 cross-reactivity.

There are conditions that are more likely than others to cause false-positives. And there are some conditions that we aren't aware of yet which may be documented in the future to cause false-positives. Some of the factors on the list have been documented only for ELISA, while some have been documented for both ELISA and Western blot (WB) tests.

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. But remember, a WB is positive by virtue of accumulating enough individual positive bands to add up to the total required by whatever criteria is used to interpret it 39. So the more exposure 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 low-risk populations may have false-positive Western blots for poorly understood reasons 47.

Since false-positives to every single HIV protein have been documented 36, how do we know if the positive WB bands represent the various proteins to HIV, or a collection of false-positive bands reacting to several different non-HIV antibodies?"

REFERENCES

 

  1. Agbalika F, Ferchal F, Garnier J-P, et al. 1992. False-positive antigens related to emergence of a 25-30 kD protein detected in organ recipients. AIDS. 6:959-962.
  2. Andrade V, Avelleira JC, Marques A, et al. 1991. Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1. Intl. J. Leprosy. 59:125.
  3. Arnold NL, Slade RA, Jones MM, et al. 1994. Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity. Vox Sanguinis. 67:191.
  4. Ascher D, Roberts C. 1993. Determination of the etiology of seroreversals in HIV testing by antibody fingerprinting. AIDS. 6:241.
  5. Barbacid M, Bolgnesi D, Aaronson S. 1980. Humans have antibodies capable of recognizing oncoviral glycoproteins: Demonstration that these antibodies are formed in response to cellular modification of glycoproteins rather than as consequence of exposure to virus. Proc. Natl. Acad. Sci. 77:1617-1621.
  6. Biggar R, Melbye M, Sarin P, et al. 1985. ELISA HTLV retrovirus antibody reactivity associated with malaria and immune complexes in healthy Africans. Lancet. ii:520-543.
  7. Blanton M, Balakrishnan K, Dumaswala U, et al. 1987. HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus. Transfusion. 27(1):118.
  8. Blomberg J, Vincic E, Jonsson C, et al. 1990. Identification of regions of HIV-1 p24 reactive with sera which give "indeterminate" results in electrophoretic immunoblots with the help of long synthetic peptides. AIDS Res. Hum. Retro. 6:1363.
  9. Burkhardt U, Mertens T, Eggers H. 1987. Comparison of two commercially available anti-HIV ELISA's: Abbott HTLV-III ELA and DuPont HTLV-III ELISA. J. Med. Vir. 23:217.
  10. Bylund D, Ziegner U, Hooper D. 1992 Review of testing for human immunodeficiency virus. Clin. Lab. Med. 12:305-333.
  11. Challakere K, Rapaport M. 1993. False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects. West. J. Med. 159(2):214-215.
  12. Charmot G, Simon F. 1990. HIV infection and malaria. Revue du practicien. 40:2141.
  13. Cordes R, Ryan M. 1995. Pitfalls in HIV testing. Postgraduate Medicine. 98:177.
  14. Dock N, Lamberson H, O'Brien T, et al. 1988. Evaluation of atypical human immunodeficiency virus immunoblot reactivity in blood donors. Transfusion. 28:142.
  15. Esteva M, Blasini A, Ogly D, et al. 1992. False positive results for antibody to HIV in two men with systemic lupus erythematosus. Ann. Rheum. Dis. 51:1071-1073.
  16. Fassbinder W, Kuhni P, Neumayer H. et al. 1986. Prevalence of antibodies against LAV/HTLV-III [HIV] in patients with terminal renal insufficiency treated with hemodialysis and following renal transplantation. Deutsche Medizinische Wochenschrift. 111:1087.
  17. Fleming D, Cochi S, Steece R. et al. 1987. Acquired immunodeficiency syndrome in low-incidence areas. JAMA. 258(6):785.
  18. Gill MJ, Rachlis A, Anand C. 1991. Five cases of erroneously diagnosed HIV infection. Can. Med. Asso. J. 145(12):1593.
  19. Healey D, Bolton W. 1993. Apparent HIV-1 glycoprotein reactivity on Western blot in uninfected blood donors. AIDS. 7:655-658.
  20. Hisa J. 1993. False-positive ELISA for human immunodeficiency virus after influenza vaccination. JID. 167:989.
  21. Isaacman S. 1989. Positive HIV antibody test results after treatment with hepatitis B immune globulin. JAMA. 262:209.
  22. Jackson G, Rubenis M, Knigge M, et al. 1988. Passive immunoneutralisation of human immunodeficiency virus in patients with advanced AIDS. Lancet, Sept. 17:647.
  23. Jindal R, Solomon M, Burrows L. 1993. False positive tests for HIV in a woman with lupus and renal failure. NEJM. 328:1281-1282.
  24. Jungkind D, DiRenzo S, Young S. 1986. Effect of using heat-inactivated serum with the Abbott human T-cell lymphotropic virus type III [HIV] antibody test. J. Clin. Micro.23:381.
  25. Kashala O, Marlink R, Ilunga M. et al. 1994. Infection with human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic viruses among leprosy patients and contacts: correlation between HIV-1 cross-reactivity and antibodies to lipoarabionomanna. J. Infect. Dis. 169:296-304.
  26. Lai-Goldman M, McBride J, Howanitz P, et al. 1987. Presence of HTLV-III [HIV] antibodies in immune serum globulin preparations. Am. J. Clin. Path. 87:635.
  27. Langedijk J, Vos W, Doornum G, et al. 1992. Identification of cross-reactive epitopes recognized by HIV-1 false-positive sera. AIDS. 6:1547-1548.
  28. Lee D, Eby W, Molinaro G. 1992. HIV false positivity after hepatitis B vaccination. Lancet. 339:1060.
  29. Leo-Amador G, Ramirez-Rodriguez J, Galvan-Villegas F, et al. 1990. Antibodies against human immunodeficiency virus in generalized lupus erythematosus. Salud Publica de Mexico. 32:15.
  30. Mackenzie W, Davis J, Peterson D. et al. 1992. Multiple false-positive serologic tests for HIV, HTLV-1 and hepatitis C following influenza vaccination, 1991. JAMA. 268:1015-1017.
  31. Mathe G. 1992. Is the AIDS virus responsible for the disease? Biomed & Pharmacother. 46:1-2.
  32. Mendenhall C, Roselle G, Grossman C, et al. 1986. False-positive tests for HTLV-III [HIV] antibodies in alcoholic patients with hepatitis. NEJM. 314:921.
  33. Moore J, Cone E, Alexander S. 1986. HTLV-III [HIV] seropositivity in 1971-1972 parenteral drug abusers - a case of false-positives or evidence of viral exposure? NEJM. 314:1387-1388.
  34. Mortimer P, Mortimer J, Parry J. 1985. Which anti-HTLV-III/LAV [HIV] assays for screening and comfirmatory testing? Lancet. Oct. 19, p873.
  35. Neale T, Dagger J, Fong R, et al. 1985. False-positive anti-HTLV-III [HIV] serology. New Zealand Med. J. October 23.
  36. Ng V. 1991. Serological diagnosis with recombinant peptides/proteins. Clin. Chem. 37:1667-1668.
  37. Ozanne G, Fauvel M. 1988. Perfomance and reliability of five commercial enzyme-linked immunosorbent assay kits in screening for anti-human immunodeficiency virus antibody in high-risk subjects. J. Clin. Micro. 26:1496.
  38. Papadopulos-Eleopulos E. 1988. Reappraisal of AIDS - Is the oxidation induced by the risk factors the primary cause? Med. Hypo. 25:151.
  39. Papadopulos-Eleopulos E, Turner V, and Papadimitriou J. 1993. Is a positive Western blot proof of HIV infection? Bio/Technology. June 11:696-707.
  40. Pearlman ES, Ballas SK. 1994. False-positive human immunodeficiency virus screening test related to rabies vaccination. Arch. Pathol. Lab. Med. 118-805.
  41. Peternan T, Lang G, Mikos N, et al. Hemodialysis/renal failure. 1986. JAMA. 255:2324.
  42. Piszkewicz D. 1987. HTLV-III [HIV] antibodies after immune globulin. JAMA. 257:316.
  43. Profitt MR, Yen-Lieberman B. 1993. Laboratory diagnosis of human immunodeficiency virus infection. Inf. Dis. Clin. North Am. 7:203.
  44. Ranki A, Kurki P, Reipponen S, et al. 1992. Antibodies to retroviral proteins in autoimmune connective tissue disease. Arthritis and Rheumatism. 35:1483.
  45. Ribeiro T, Brites C, Moreira E, et al. 1993. Serologic validation of HIV infection in a tropical area. JAIDS. 6:319.
  46. Sayers M, Beatty P, Hansen J. 1986. HLA antibodies as a cause of false-positive reactions in screening enzyme immunoassays for antibodies to human T-lymphotropic virus type III [HIV]. Transfusion. 26(1):114.
  47. Sayre KR, Dodd RY, Tegtmeier G, et al. 1996. False-positive human immunodeficiency virus type 1 Western blot tests in non-infected blood donors. Transfusion. 36:45.
  48. Schleupner CJ. Detection of HIV-1 infection. In: (Mandell GI, Douglas RG, Bennett JE, eds.) Principles and Practice of Infectious Diseases, 3rd ed. New York: Churchill Livingstone, 1990:1092.
  49. Schochetman G, George J. 1992. Serologic tests for the detection of human immunodeficiency virus infection. In AIDS Testing Methodology and Management Issues, Springer-Verlag, New York.
  50. Simonsen L, Buffington J, Shapiro C, et al. 1995. Multiple false reactions in viral antibody screening assays after influenza vaccination. Am. J. Epidem. 141-1089.
  51. Smith D, Dewhurst S, Shepherd S, et al. 1987. False-positive enzyme-linked immunosorbent assay reactions for antibody to human immunodeficiency virus in a population of midwestern patients with congenital bleeding disorders. Transfusion. 127:112.
  52. Snyder H, Fleissner E. 1980. Specificity of human antibodies to oncovirus glycoproteins; Recognition of antigen by natural antibodies directed against carbohydrate structures. Proc. Natl. Acad. Sci. 77:1622-1626.
  53. Steckelberg JM, Cockerill F. 1988. Serologic testing for human immunodeficiency virus antibodies. Mayo Clin. Proc. 63:373.
  54. Sungar C, Akpolat T, Ozkuyumcu C, et al. Alpha interferon therapy in hemodialysis patients. Nephron. 67:251.
  55. Tribe D, Reed D, Lindell P, et al. 1988. Antibodies reactive with human immunodeficiency virus gag-coated antigens (gag reactive only) are a major cause of enzyme-linked immunosorbent assay reactivity in a bood donor population. J. Clin. Micro. April:641.
  56. Ujhelyi E, Fust G, Illei G, et al. 1989. Different types of false positive anti-HIV reactions in patients on hemodialysis. Immun. Let. 22:35-40.