Serum samples of 62 African patients who had clinical manifestations of HIV-1 infection but were seronegative for HIV-1 by ELISA (Organon) were subsequently further tested by another HIV-1 ELISA test (Wellcozyme), HIV-1 IgG Western blot, HIV-1 antigen detection and HIV-2 ELISA. Patients’ lymphocytes were cultured for HIV-1 and 2. Because of limited quantities of serum available all tests were not performed on all samples. Seven (26%) of 27 sera of patients meeting the WHO clinical case definition of AIDS were Western-blot-positive. In contrast, of 35 patients’ sera with possible HIV related disease, only one (3%) was Western blot positive (P=0.02) and none of 75 sera from HIV-1 ELISA (Organon) seronegative blood donors (P<0.01) were Western blot positive. Of 30 HIV-1 ELISA (Organon) seronegative patients tested with the HIV-1 ELISA Wellcozyme assay only one was seropositive (this patient’s serum was also Western blot positive). Of 17 HIV-1 ELISA (Organon) seronegative patients tested, HIV-1 antigen was found in 1 case (6%) (this patient’s serum was Western blot negative). None of the 34 patients tested by HIV-2 serology was HIV-2 seropositive. HIV-1 was isolated by culture in 3 (21%) of 14 HIV-1 ELISA seronegative patients (sera of the 3 patients were Western blot negative). In total, 12 (19%) of 62 HIV-1 ELISA (Organon) seronegative patients were found to be positive for HIV, either by Western blot HIV antigen testing or viral culture. This study suggests that, in Africa, in populations of high HIV-1 seroprevalence, additional tests to demonstrate HIV infection should be performed on patients who have clinical manifestations strongly suggestive of HIV infection, but who are HIV-1 ELISA seronegative.
- AIDS diagnosis
- HIV enzyme-linked immunoassay
- HIV infection
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Pharmacology (medical)
- Infectious Diseases