Accession Number : ADA259058


Title :   Indeterminate HIV-1 Western Blots: Etiology, Natural History, and Psychological Reactions


Descriptive Note : Final rept. 17 Aug 1990-16 Aug 1992


Corporate Author : WASHINGTON UNIV SEATTLE


Personal Author(s) : Celum, Connie


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/a259058.pdf


Report Date : 16 Sep 1992


Pagination or Media Count : 105


Abstract : Previously described causes of indeterminate HIV-1 Western blots (IWB) include the evolving antibody response during HIV-1 seroconversion, antibody cross-reactivity due to HfV-2 infection, autoimmune disease, and alcoholic hepatitis. Most cases of IWB remain unexplained, however. Two hundred forty-four cases were referred to the study because of one or more previous repeatedly reactive HIV-1 enzyme immunoassay (EIA) and IWB and 145 EIA negative controls were frequency-matched by testing site. Risk factors for fWB were evaluated among the 123 cases who were still EIA repeatedly reactive with an IWB at visit one and 112 controls who were both EIA and Western blot negative. Six (3.4%; 95% CI=0.6%, 6.1%) of the 178 cases who were followed for six months or longer seroconverted. The specificities of HIV-1 culture, PCR, serum p24 antigen, the recombinant Cambridge BioSciences Recombugen (or, CBr3), Syva Microtrak, and the synthetic peptide assay, Genetic Systems GENIE, were 97-100% among the nonseroconverters. Independent risk factors for IWB among the nonseroconverter cases were: autoantibodies (positive antinuclear antibodies or rheumatoid factor) (O.R. 2.3; 95% CI=1.2,4.5); sexual contact with a prostitute since 1978 (O.R. 5.6; 95% CI=1.5, 21), history of STDs (O.R. 0.5, 95% CI=0.2,0. 9), and elective testing for HIV (O.R. 2.3; 95% CI=1.1,4.7). Separate analyses for men and women showed different risk factors for IWB. women, parity (O.R. 1. 4; 95% CI=1.1,1.7) and elective testing for HIV (O.R. 3.8; 95% CI=1.4,10.4) were positively associated with IWB, and history of STDs (O.R. 0.2; 95% CI=0.08,0.6) was negatively associated with an IWB.


Descriptors :   *HUMAN IMMUNODEFICIENCY VIRUSES , *NATURAL HISTORY , *REACTION(PSYCHOLOGY) , TEST AND EVALUATION , FREQUENCY , CONTROL , HIGH RATE , RISK , PEPTIDES , ENZYMES , SITES , DISEASES , REACTIVITIES , RESPONSE , ETIOLOGY , HISTORY , ANTIBODIES , INFECTIOUS DISEASES , BLOOD SERUM , IMMUNOASSAY , LOW RATE , PARITY , CULTURE , GENETICS , ANTIGENS , HEPATITIS , SEX , ACQUIRED IMMUNE DEFICIENCY SYNDROME , TETANUS , RETROVIRUSES , AUTOIMMUNE DISEASES , BLOOD DONORS


Subject Categories : Medicine and Medical Research
      Microbiology


Distribution Statement : APPROVED FOR PUBLIC RELEASE