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False positive HIV screening test among syphilis patients
A Azraan
Reasons for false HIV positive screening test
bull Cross-reactive antibodies to some human leukocyte antigens (HLA) that develop as the result of prior blood transfusion or during multiple pregnancies
bull Auto-antibodies found in some rheumatologic diseasesbull Receipt of gamma-globulinbull Recent vaccination (influenza hepatitis)bull Renal transplantationbull Some liver diseasesbull Some cancersbull EBV infectionbull Technical errors in testing
Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad Med 1995 Nov98(5)177-80 185-6 189
Search engines and key words
bull Pub Medbull Medlinebull MD Consultbull Google scholar bull Cochrane Collaboration
bull False positive HIVbull Syphilis and false positive HIV
Available screening tests for HIV
1 HIV enzyme linked immunosorbent assay ( HIV Elisa ) ndash Gens screen
2 Particle agglutination Test (PA) - Serodia3 Rapid Test kits
Test Sensitivity SpecificityHIV Elisa (4th G ) 100 999HIV Elisa (3rd G ) 993 997HIV PA (serodia) 100 998
Testing algorithmA1
Reactive inconclusive
A1 and A2
Reactive or inconclusive one
test
A3
Positive Indeterminate Negative
Both Negative
Negative
Second Sample for confirmation
Follow up
bull Western Blot 2 envelope protein plusmn gag or pol
Indeterminate results on WB
Repeat in 6 week with appropriate strategy
Longer follow up 36 and 12 months
If indeterminate beyond 1 year declare as negative
Study methodbull A case seriesbull Clinic based descriptive studybull Selected cases from 3 clinics from 2007-2013
ndash Central STD clinicndash STD Clinic Kalubowilandash STD clinic Ragama
bull Eligibility criteriandash Positive syphilis serology at the time of diagnosisndash Positive or indeterminate HIV screening test at the time of
diagnosis of syphilisndash Subsequent negative or indeterminate HIV confirmatory
test results
Results
bull 24 cases identified
10 42
13 54
1 4
Clinic representation
Central ClinicKalubowila ClinicRagama Clinic
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Reasons for false HIV positive screening test
bull Cross-reactive antibodies to some human leukocyte antigens (HLA) that develop as the result of prior blood transfusion or during multiple pregnancies
bull Auto-antibodies found in some rheumatologic diseasesbull Receipt of gamma-globulinbull Recent vaccination (influenza hepatitis)bull Renal transplantationbull Some liver diseasesbull Some cancersbull EBV infectionbull Technical errors in testing
Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad Med 1995 Nov98(5)177-80 185-6 189
Search engines and key words
bull Pub Medbull Medlinebull MD Consultbull Google scholar bull Cochrane Collaboration
bull False positive HIVbull Syphilis and false positive HIV
Available screening tests for HIV
1 HIV enzyme linked immunosorbent assay ( HIV Elisa ) ndash Gens screen
2 Particle agglutination Test (PA) - Serodia3 Rapid Test kits
Test Sensitivity SpecificityHIV Elisa (4th G ) 100 999HIV Elisa (3rd G ) 993 997HIV PA (serodia) 100 998
Testing algorithmA1
Reactive inconclusive
A1 and A2
Reactive or inconclusive one
test
A3
Positive Indeterminate Negative
Both Negative
Negative
Second Sample for confirmation
Follow up
bull Western Blot 2 envelope protein plusmn gag or pol
Indeterminate results on WB
Repeat in 6 week with appropriate strategy
Longer follow up 36 and 12 months
If indeterminate beyond 1 year declare as negative
Study methodbull A case seriesbull Clinic based descriptive studybull Selected cases from 3 clinics from 2007-2013
ndash Central STD clinicndash STD Clinic Kalubowilandash STD clinic Ragama
bull Eligibility criteriandash Positive syphilis serology at the time of diagnosisndash Positive or indeterminate HIV screening test at the time of
diagnosis of syphilisndash Subsequent negative or indeterminate HIV confirmatory
test results
Results
bull 24 cases identified
10 42
13 54
1 4
Clinic representation
Central ClinicKalubowila ClinicRagama Clinic
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Search engines and key words
bull Pub Medbull Medlinebull MD Consultbull Google scholar bull Cochrane Collaboration
bull False positive HIVbull Syphilis and false positive HIV
Available screening tests for HIV
1 HIV enzyme linked immunosorbent assay ( HIV Elisa ) ndash Gens screen
2 Particle agglutination Test (PA) - Serodia3 Rapid Test kits
Test Sensitivity SpecificityHIV Elisa (4th G ) 100 999HIV Elisa (3rd G ) 993 997HIV PA (serodia) 100 998
Testing algorithmA1
Reactive inconclusive
A1 and A2
Reactive or inconclusive one
test
A3
Positive Indeterminate Negative
Both Negative
Negative
Second Sample for confirmation
Follow up
bull Western Blot 2 envelope protein plusmn gag or pol
Indeterminate results on WB
Repeat in 6 week with appropriate strategy
Longer follow up 36 and 12 months
If indeterminate beyond 1 year declare as negative
Study methodbull A case seriesbull Clinic based descriptive studybull Selected cases from 3 clinics from 2007-2013
ndash Central STD clinicndash STD Clinic Kalubowilandash STD clinic Ragama
bull Eligibility criteriandash Positive syphilis serology at the time of diagnosisndash Positive or indeterminate HIV screening test at the time of
diagnosis of syphilisndash Subsequent negative or indeterminate HIV confirmatory
test results
Results
bull 24 cases identified
10 42
13 54
1 4
Clinic representation
Central ClinicKalubowila ClinicRagama Clinic
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Available screening tests for HIV
1 HIV enzyme linked immunosorbent assay ( HIV Elisa ) ndash Gens screen
2 Particle agglutination Test (PA) - Serodia3 Rapid Test kits
Test Sensitivity SpecificityHIV Elisa (4th G ) 100 999HIV Elisa (3rd G ) 993 997HIV PA (serodia) 100 998
Testing algorithmA1
Reactive inconclusive
A1 and A2
Reactive or inconclusive one
test
A3
Positive Indeterminate Negative
Both Negative
Negative
Second Sample for confirmation
Follow up
bull Western Blot 2 envelope protein plusmn gag or pol
Indeterminate results on WB
Repeat in 6 week with appropriate strategy
Longer follow up 36 and 12 months
If indeterminate beyond 1 year declare as negative
Study methodbull A case seriesbull Clinic based descriptive studybull Selected cases from 3 clinics from 2007-2013
ndash Central STD clinicndash STD Clinic Kalubowilandash STD clinic Ragama
bull Eligibility criteriandash Positive syphilis serology at the time of diagnosisndash Positive or indeterminate HIV screening test at the time of
diagnosis of syphilisndash Subsequent negative or indeterminate HIV confirmatory
test results
Results
bull 24 cases identified
10 42
13 54
1 4
Clinic representation
Central ClinicKalubowila ClinicRagama Clinic
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Testing algorithmA1
Reactive inconclusive
A1 and A2
Reactive or inconclusive one
test
A3
Positive Indeterminate Negative
Both Negative
Negative
Second Sample for confirmation
Follow up
bull Western Blot 2 envelope protein plusmn gag or pol
Indeterminate results on WB
Repeat in 6 week with appropriate strategy
Longer follow up 36 and 12 months
If indeterminate beyond 1 year declare as negative
Study methodbull A case seriesbull Clinic based descriptive studybull Selected cases from 3 clinics from 2007-2013
ndash Central STD clinicndash STD Clinic Kalubowilandash STD clinic Ragama
bull Eligibility criteriandash Positive syphilis serology at the time of diagnosisndash Positive or indeterminate HIV screening test at the time of
diagnosis of syphilisndash Subsequent negative or indeterminate HIV confirmatory
test results
Results
bull 24 cases identified
10 42
13 54
1 4
Clinic representation
Central ClinicKalubowila ClinicRagama Clinic
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Follow up
bull Western Blot 2 envelope protein plusmn gag or pol
Indeterminate results on WB
Repeat in 6 week with appropriate strategy
Longer follow up 36 and 12 months
If indeterminate beyond 1 year declare as negative
Study methodbull A case seriesbull Clinic based descriptive studybull Selected cases from 3 clinics from 2007-2013
ndash Central STD clinicndash STD Clinic Kalubowilandash STD clinic Ragama
bull Eligibility criteriandash Positive syphilis serology at the time of diagnosisndash Positive or indeterminate HIV screening test at the time of
diagnosis of syphilisndash Subsequent negative or indeterminate HIV confirmatory
test results
Results
bull 24 cases identified
10 42
13 54
1 4
Clinic representation
Central ClinicKalubowila ClinicRagama Clinic
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Study methodbull A case seriesbull Clinic based descriptive studybull Selected cases from 3 clinics from 2007-2013
ndash Central STD clinicndash STD Clinic Kalubowilandash STD clinic Ragama
bull Eligibility criteriandash Positive syphilis serology at the time of diagnosisndash Positive or indeterminate HIV screening test at the time of
diagnosis of syphilisndash Subsequent negative or indeterminate HIV confirmatory
test results
Results
bull 24 cases identified
10 42
13 54
1 4
Clinic representation
Central ClinicKalubowila ClinicRagama Clinic
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Results
bull 24 cases identified
10 42
13 54
1 4
Clinic representation
Central ClinicKalubowila ClinicRagama Clinic
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
20 83
4 17
Sex distribution
MaleFemale
0
2
4
6
8
10
12
10-19 age
20-29 30-39 40-49 50+
Age distribution
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
11 46
13 54
Initial HIV screening test
ELISAPA
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
7 29
11 46
5 21
1 4
Stage of syphilis
Primary syphilis
Secondary syp
Early latent
SUD
0
1
2
3
4
5
6
7
8
R8 R16 R32 R64 R128
Initial VDRL titer
75
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
HIV test result of the second sample Case Particle agg test ELISA Confirmatory (WBLB)
Case 1 Indeterminate Negative Negative
Case 2 Not done Negative on 2 tests Not done
Case 3 Indeterminate Negative Negative
Case 4 Negative Negative Not done
Case 5 Reactive Negative Negative
Case 6 Indeterminate Negative Negative
Case 7 Indeterminate Negative Negative
Case 8 Indeterminate Negative Negative
Case 9 Indeterminate Negative Negative
Case 10 Reactive Negative Negative
Case 11 Reactive Negative Indeterminate
Case 12 Reactive Negative Indeterminate
Case 13 Reactive Weakly reactive Indeterminate
Case 14 Indeterminate Weakly reactive Negative
Case 15 Negative Reactive Negative
Case 16 Negative Weakly reactive Negative
Case 17 Negative Reactive Indeterminate
Case 18 Negative Weakly reactive Negative
Case 19 Negative Reactive Negative
Case 20 Indeterminate Weakly reactive Indeterminate
Case 21 Negative Weakly reactive Negative
Case 22 Negative Weakly reactive Indeterminate
Case 23 Negative Weakly reactive Negative
Case 24 Negative Weakly reactive Indeterminate
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Initial HIV confirmatory test
CasesConfirmatory test results
Total cases
24
Indeterminate 07
Negative 15
Not done 02
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Treatment response
02468
1012141618
Treatment modality
17 71
7 29
Treatment response
4 fold dropdefaulted
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Follow up HIV testing
Follow up HIV screening amp confirmatory in appropriate
casesCasesConfirmatory test
resultsTotal cases
24
Indeterminate 07 Negative (05)
Default (02)
Negative 15 Negative (08)
Default (07)
Not done 02 Negative (01)
Default (01)
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Initial VDRL titer VDRL titer at subsequent HIV test
012345678
012345678
R8 R16 R32 R64 R128
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Summary
bull Out of 24 cases with reactive or indeterminate HIV screening test results 22 became negative subsequently
bull Almost all cases (23) were diagnosed as early syphilis
bull 17 cases were excluded HIV infection initially by confirmatory test and 57 of the remaining were excluded by subsequent tests
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Conclusion
bull Possibility of false positive HIV screening test in early syphilis with high VDRL titer
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
Acknowledgement
bull Dr N Abeygunasekara Consultant Venereologist STD clinic ndash Kalubowila
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
References1 Pitfalls in HIV testing Application and limitations of current tests Cordes RJ1 Ryan ME Postgrad
Med 1995 Nov98(5)177-80 185-6 1892 Centers for Disease Control Update Serologic testing for antibody to human immunodeficiency virus
MMWR 198836833-40 8453 False human immunodeficiency virus test results associated with rheumatoid factors in rheumatoid
arthritis Li YC Yang F Ji XY Fang ZJ Liu J Wang Y Chineese medical science journal 2014 Jun29(2)103-6
4 Agbalika F Ferchal F Garnier J-P et al 1992 False-positive antigens related to emergence of a 25-30 kDprotein detected in organ recipients AIDS 6959-962
5 Andrade V Avelleira JC Marques A et al 1991 Leprosy as a cause of false-positive results in serological assays for the detection of antibodies to HIV-1 Intl J Leprosy 59125
6 Arnold NL Slade RA Jones MM et al 1994 Donor follow up of influenza vaccine-related multiple viral enzyme immunoassay reactivity Vox Sanguinis 67191
7 Blanton M Balakrishnan K Dumaswala U et al 1987 HLA antibodies in blood donors with reactive screening tests for antibody to the immunodeficiency virus Transfusion 27(1)118
8 Challakere K Rapaport M 1993 False-positive human immunodeficiency virus type 1 ELISA results in low-risk subjects West J Med 159(2)214-215
9 Esteva M Blasini A Ogly D et al 1992 False positive results for antibody to HIV in two men with systemic lupus erythematosus Ann Rheum Dis 511071-1073
10 Isaacman S 1989 Positive HIV antibody test results after treatment with hepatitis B immune globulin JAMA 262209
11 Mackenzie W Davis J Peterson D et al 1992 Multiple false-positive serologic tests for HIV HTLV-1 and hepatitis C following influenza vaccination 1991 JAMA 2681015-1017
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-
- False positive HIV screening test among syphilis patients
- Reasons for false HIV positive screening test
- Search engines and key words
- Available screening tests for HIV
- Testing algorithm
- Follow up
- Study method
- Results
- Slide Number 9
- Slide Number 10
- Slide Number 11
- Slide Number 12
- Initial HIV confirmatory test
- Treatment response
- Follow up HIV testing
- Slide Number 16
- Summary
- Conclusion
- Acknowledgement
- References
- Slide Number 21
-