False-Positive Human Immunodeficiency Virus Enzyme Immunoassay Results in Pregnant Women 英文参考文献.docVIP

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False-Positive Human Immunodeficiency Virus Enzyme Immunoassay Results in Pregnant Women 英文参考文献.doc

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False-Positive Human Immunodeficiency Virus Enzyme Immunoassay Results in Pregnant Women 英文参考文献

False-PositiveHumanImmunodeficiencyVirusEnzyme ImmunoassayResultsinPregnantWomen LauraG.Wesolowski*,KevinP.Delaney,MargaretA.Lampe,StevenR.Nesheim DivisionofHIV/AIDSPrevention,NationalCenterforHIV/AIDS,ViralHepatitis,STD,andTBPrevention,CentersforDiseaseControlandPrevention,Atlanta,Georgia,United StatesofAmerica Abstract Objective: Examine whether false-positive HIV enzyme immunoassay (EIA) test results occur more frequently among pregnantwomenthanamongwomenwhoarenotpregnantandmen(others). Design: To obtain a large number of pregnant women and others tested for HIV, we identified specimens tested at a nationallaboratoryusingGeneticSystemsHIV-1/HIV-2PlusOEIAfromJuly2007toJune2008. Methods:SpecimenswithEIArepeatedlyreactiveandWesternblot-negativeorindeterminateresultswereconsideredEIA false-positive. We compared the false-positive rate among uninfected pregnant women and others, adjusting for HIV prevalence. Among all reactive EIAs, we evaluated the proportion of false-positives, positive predictive value (PPV), and Westernblotbandsamongindeterminates,bypregnancystatus. Results:HIVprevalencewas0.06%among921,438pregnantwomenand1.34%among1,103,961others.Thefalse-positive rate was lower for pregnant women than others (0.14% vs. 0.21%, odds ratio 0.65 [95% confidence interval 0.61, 0.70]). PregnantwomenwithreactiveEIAsweremorelikelythanothers(p,0.01)tohaveWesternblot-negative(52.9%vs.9.8%) andindeterminateresults(17.0%vs.3.7%)andlowerPPV(30%vs.87%).Thep24bandwasdetectedmoreoftenamong pregnantwomen(p,0.01). Conclusions: False-positive HIV EIA results were rare and occurred less frequently among pregnant women than others. PregnantwomenwithreactiveEIAsweremorelikelytohavenegativeandindeterminateWesternblotresultsduetolower HIVprevalenceandhigherp24reactivity,respectively.Indeterminateresultsmaycomplicateclinicalmanagementduring pregnancy. Alternative methods are needed to rule out infection in persons with reactive EIAs from low prevalence populations. Citation:Wesolowski