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DOI: 10.1055/s-0030-1270114
The Pattern of Indeterminate Human Immunodeficiency Virus Test and Follow-Up Evaluation in Pregnant Women
Publication History
Publication Date:
06 December 2010 (online)
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ABSTRACT
We studied the pattern of indeterminate HIV serological tests among pregnant women with follow-up testing in the postpartum period. Medical records of pregnant women were reviewed over a 2-year period. Of 16,596 pregnant women, 127 (0.8%) had positive HIV enzyme-linked immunoassay (ELISA) result. With Western blot (WB) test, 54 (0.33%) were positive, 43 (0.26%) were negative, and 30 (0.18%) were indeterminate. One of the 30 women (3.3%) with indeterminate WB converted to positive WB during pregnancy. White and black women were more likely to have an unconfirmed positive ELISA (indeterminate or negative WB) than Hispanics (p = 0.021). The positive WB rate for black women was significantly higher (p < 0.001) than other racial/ethnic groups. The postpartum follow-up testing of 14 women with indeterminate WB varied between 4 to 20 weeks; 16 did not have any postpartum follow-up test. The common bands in indeterminate WB were P24, P18, and nonviral proteins. The pattern of indeterminate WB result and its follow-up was variable during pregnancy and postpartum period. There is a need for development of national standards of care for indeterminate WB mothers and their infants in the postpartum period. Additional studies are needed to determine the cause of indeterminate tests, reducing their occurrence in the testing process, and the optimum time for testing in the postpartum period.
KEYWORDS
Indeterminate Western blot - HIV test - pregnancy
REFERENCES
- 1 Centers for Disease Control and Prevention . U.S. Public Health Service recommendations for human immunodeficiency virus counseling and voluntary testing for pregnant women. MMWR Recomm Rep. 1995; 44 (RR-7) 1-15
- 2 Cremonezi D, Mesquita P E, Romão M M, Prestes-Carneiro L E. Prevalence of indeterminate human immunodeficiency virus western blot results in pregnant women attended at a public hospital in Presidente Prudente, Brazil. Braz J Infect Dis. 2005; 9 506-509
- 3 Alexander T S, Lee J, Yen-Lieberman B. Incidence of human immunodeficiency virus antibody in a prenatal population at a community hospital. Clin Diagn Lab Immunol. 1999; 6 140-141
- 4 Zacharias N M, Athanassaki I D, Sangi-Haghpeykar H, Gardner M O. High false-positive rate of human immunodeficiency virus rapid serum screening in a predominantly Hispanic prenatal population. J Perinatol. 2004; 24 743-747
- 5 Centers for Disease Control and Prevention . Revised guidelines for HIV counseling, testing, and referral. MMWR Recomm Rep. 2001; 50 (RR-19) 1-57 quiz CE1, a1-CE6, a1
- 6 Centers for Disease Control (CDC) . Interpretive criteria used to report western blot results for HIV-1-antibody testing—United States. MMWR Morb Mortal Wkly Rep. 1991; 40 692-695
- 7 Johnson J P, Vink P E, Hines S E, Robinson B, Davis Jr J C, Nair P. Vertical transmission of human immunodeficiency virus from seronegative or indeterminate mothers. Am J Dis Child. 1991; 145 1239-1241
- 8 Dock N L, Lamberson Jr H V, O'Brien T A, Tribe D E, Alexander S S, Poiesz B J. Evaluation of atypical human immunodeficiency virus immunoblot reactivity in blood donors. Transfusion. 1988; 28 412-418
- 9 Celum C L, Coombs R W, Jones M et al.. Risk factors for repeatedly reactive HIV-1 EIA and indeterminate western blots. A population-based case-control study. Arch Intern Med. 1994; 154 1129-1137
- 10 Magee L A, Murphy K E, von Dadelszen P. False-positive results in antenatal HIV screening. CMAJ. 1999; 160 1285
- 11 Matemo D, Kinuthia J, John F et al.. Indeterminate rapid HIV-1 test results among antenatal and postnatal mothers. Int J STD AIDS. 2009; 20 790-792
Sangeeta JainM.D. M.M.S.
Assistant Professor, Department of Obstetrics and Gynecology, University of Texas Medical Branch
301 University Blvd, Galveston, TX 77555-0587
Email: sajain@utmb.edu