Prevalence of HIV Indeterminate Western Blot Tests and Follow-up of HIV Antibody Sero-Conversion in Southeastern China
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HIV-indeterminate Western blotting (WB) results are typically obtained in WB confirmatory assays, and the number of indeterminate samples may increase with the detection of HIV infections, which will present considerable challenges for the management of HIV/AIDS. Nucleic acid detection has been used as a laboratory test for screening suspected or indeterminate samples. However, the effectiveness of these assays for the differential diagnosis of HIV-indeterminate WB samples remained undetermined. In this study, 210 subjects with HIV-indeterminate WB results were detected from 6360 positive HIV screening samples between 2015 and 2016 in southeastern China, in which HIV-indeterminate WB results accounted for 3.30%. The highest proportion of indeterminate results was observed in pregnant and lying-in women receiving physical examinations (16.67%), followed by that in voluntary blood donors (8.82%). The most common WB band patterns were p24, gp160 and p24, and gp160. The follow-up study revealed that the highest negative and positive conversion rates of HIV antibodies were in samples with a single p24 band (80.28%), and with gp160 and p24 bands (86.21%), respectively. Among the Env, Gag, and Pol antibodies, samples with a Gag band showed the highest negative conversion rate (81.25%), whereas the highest positive conversion rate was observed in samples with an Env band (56.76%). In addition, quantitative and qualitative HIV nucleic acid testing exhibited the highest sensitivity (96.3%) and specificity (97.85%), respectively. Our results indicate a lower proportion of HIV indeterminate WB results in southeastern China compared to previous reports, and the follow-up re-examination of patients with HIV indeterminate results should be performed. Nucleic acid testing facilitates the identification of HIV infections.
KeywordsHuman immunodeficiency virus (HIV) HIV indeterminate result Western blotting Nucleic acid test Differential diagnosis
We would like to thank Drs. Hanhui Ye, Yahong Chen, and Xiaoyan Lin from the Mengchao Hepatobiliary Hospital of Fujian Medical University, and the Centers for Disease Control and Prevention in all cities of Fujian Province, for their kind assistance during the investigation. This study was supported by grants from the Cultivation of Young Talents Project Fund from the Fujian Provincial Health and Family Planning Commission (Grant No. 2015-ZQN-ZD-11), the Pilot Project of Fujian Provincial Department of Science and Technology (Grant No. 2016Y0010), and the Jiangsu Provincial Project of Invigorating Health Care through Science, Technology and Education and Jiangsu Provincial Medical Youth Talent, the Project of Invigorating Health Care through Science, Technology and Education (Grant No. QNRC2016621).
SW, PY and YY designed the experiments. SW, MG and JZ carried out the experiments. SW, MG, WW, XL and YQ analyzed the data. SW, MG and WW wrote the paper. SW and YY checked and finalized the manuscript. All authors read and approved the final manuscript.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interests.
Animal and Human Rights Statement
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Ethical Review Committee of Fujian Municipal Center for Disease Control and Prevention and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all participants enrolled in the study.
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