Association of schistosomiasis with false positive HIV test results in an African adolescent population.


Everett, DB; Baisley, KJ; McNerney, R; Hambleton, I; Chirwa, T; Ross, DA; Changalucha, J; Watson-Jones, D; Helmby, H; Dunne, DW; Mabey, D; Hayes, RJ; (2010) Association of schistosomiasis with false positive HIV test results in an African adolescent population. Journal of clinical microbiology, 48 (5). pp. 1570-7. ISSN 0095-1137 DOI: https://doi.org/10.1128/JCM.02264-09

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Abstract

This study was designed to investigate the factors associated with the high rate of false-positive test results observed with the 4th-generation Murex HIV Ag/Ab Combination EIA (enzyme immunoassay) within an adolescent and young-adult cohort in northwest Tanzania. (4th-generation assays by definition detect both HIV antigen and antibody.) The clinical and sociodemographic factors associated with false-positive HIV results were analyzed for 6,940 Tanzanian adolescents and young adults. A subsample of 284 Murex assay-negative and 240 false-positive serum samples were analyzed for immunological factors, including IgG antibodies to malaria and schistosoma parasites, heterophile antibodies, and rheumatoid factor (RF) titers. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). False-positive HIV test results were associated with evidence of other infections. False positivity was strongly associated with increasing levels of Schistosoma haematobium worm IgG1, with adolescents with optical densities in the top quartile being at the highest risk (adjusted OR=40.7, 95% CI=8.5 to 194.2 compared with the risk for those in the bottom quartile). False positivity was also significantly associated with increasing S. mansoni egg IgG1 titers and RF titers of >or=80 (adjusted OR=8.2, 95% CI=2.8 to 24.3). There was a significant negative association between Murex assay false positivity and the levels of S. mansoni worm IgG1 and IgG2 and Plasmodium falciparum IgG1 and IgG4. In Africa, endemic infections may affect the specificities of immunoassays for HIV infection. Caution should be used when the results of 4th-generation HIV test results are interpreted for African adolescent populations.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
Tropical Epidemiology Group
PubMed ID: 20181896
Web of Science ID: 277356600009
URI: http://researchonline.lshtm.ac.uk/id/eprint/4053

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