Journal of Clinical Immunology

, Volume 12, Issue 3, pp 185–192 | Cite as

Indeterminate western blot patterns in a cohort of individuals at high risk for human immunodeficiency virus (HIV-1) exposure

  • Richard T. DaveyJr.
  • Lawrence R. Deyton
  • Julia A. Metcalf
  • Margaret Easter
  • Joseph A. Kovacs
  • M. Vasudevachari
  • Miltiades Psallidopoulos
  • Louis M. ThompsonIII
  • Judy Falloon
  • Michael A. Polis
  • Henry Masur
  • H. Clifford Lane
Original Articles

Abstract

Our objective was to map serial patterns of Western blot reactivity over time of a cohort of initially ELISA-negative, Western blot-indeterminate individuals from a high-risk group and to determine if these individuals were at increased risk of harboring occult HIV-1 infection. A 2-year prospective study used serial ELISA, two types of Western blot, immunologic profiles, HIV-1 culture, and analysis by polymerase chain reaction. Subjects were 20 ELISA-negative, Western blot indeterminate homosexual volunteers and 20 matched seronegative controls. Results showed that 19 of 20 study subjects completed a mean of 17.0 months of clinical and laboratory follow-up. Reactivities with p24 and/or with p55 were the two most commonly observed Western blot patterns, occurring in 70% of individuals. Specific Western blot reactivity was dependent upon the particular immunoblot preparation being used and varied considerably on a longitudinal basis. No individual pattern appeared predictive of an increased likelihood of subsequent seroconversion to HIV-1 relative to controls. By all other criteria including polymerase chain reaction analysis, samples from 17 of 19 individuals remained negative for HIV-1 at each time point. Two individuals evolved from an indeterminate to a positive Western blot and, simultaneously, from a negative to a positive polymerase chain reaction analysis, during follow-up. Our conclusions were as follows. ELISA-negative, Western blot-indeterminate individuals from a high-risk group show marked variability in immunoblot findings over time, and these patterns do not appear predictive of an increased likelihood of infection. Polymerase chain reaction analysis is clearly of value in providing confirmation of the low probability of infection in this group, although in patients who do become infected, detection by this test may not always precede diagnosis by serologic methods.

Key words

Indeterminate Western blot serology human immunodeficiency virus (HIV-1) polymerase chain reaction 

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Copyright information

© Plenum Publishing Corporation 1992

Authors and Affiliations

  • Richard T. DaveyJr.
    • 1
  • Lawrence R. Deyton
    • 1
  • Julia A. Metcalf
    • 1
  • Margaret Easter
    • 1
  • Joseph A. Kovacs
    • 2
  • M. Vasudevachari
    • 3
  • Miltiades Psallidopoulos
    • 3
  • Louis M. ThompsonIII
    • 3
  • Judy Falloon
    • 2
  • Michael A. Polis
    • 2
  • Henry Masur
    • 2
  • H. Clifford Lane
    • 1
  1. 1.Clinical and Molecular Retrovirology Section, Laboratory of ImmunoregulationNational Institute of Allergy and Infectious Diseases, NIHBethesda
  2. 2.Critical Care Medicine DepartmentNIHBethesda
  3. 3.Division of Molecular Virology & ImmunologyGeorgetown UniversityWashington, D.C.

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