HIV Reactive Test Issue (I am a vaccine non-responder)

05. april 2011 ob 13:16 | 1413
Manufacturer Disclaimers

The fine print on the information provided with HIV test kits can be very revealing for its warnings about limitations of the tests.

ā€œA Reactive result indicates that HIV-1 RNA was detected. For a specimen that is repeatedly reactive on an HIV-1 antibody test and reactive in the APTIMA HIV-1 RNA Qualitative Assay, the individual is considered confirmed infected with HIV-1ā€¦A specimen that is reactive in the APTIMA HIV-1 RNA Qualitative Assay but that has not been tested in an HIV-1 antibody test should be further tested using a licensed test for HIV-1 antibodies.ā€

Aptima HIV-1 RNA qualitative assay. Gen-Probe. 2006 Oct
http://davidcrowe.ca/SciHe

althEnv/papers/6983-Aptima

HIV-1RNAQualitativeAssay.p

df
ā€œClinical data has not been collected to demonstrate the performance of the OraQuick ADVANCE Rapid HIV-1/2 Antibody Test in persons under 12 years of age. A reactive testā€¦suggests the presence of HIV-1 and/or HIV-2 antibodiesā€¦[this test] is intended as an aid in the diagnosis of infection with HIV-1 and/or HIV-2. AIDS and AIDS-related conditions are clinical syndromes and their diagnosis can only be established clinically. For a reactive result, the intensity of the test line does not necessarily correlate with the titer [amount] of antibody in the specimenā€¦A person who has antibodies to HIV-1 or HIV-2 is presumed to be infected with the virus, except that a person who has participated in an HIV vaccine study may develop antibodies to the vaccine and may or may not be infected with HIV.ā€

OraQuick Advance rapid HIV-1/2 antibody test. OraSure. 2005 Apr
http://www.orasure.com/upl

oaded/398.pdf
ā€œA person who has antibodies to HIV-1 is presumed[!] to be infected with the virus, except that a person who has participated in an HIV vaccine study may develop antibodies to the vaccine and may or may not be infected with HIV. Clinical correlation is indicated with appropriate counseling, medical evaluation and possibly additional testing to decide whether a diagnosis of HIV infection is accurateā€¦Reactivity at or only slightly above the Cutoff Value is more frequently nonspecific, especially in samples obtained from persons at low risk for HIV infectionā€¦At present, there is no recognized standard for establishing the presence or absence of antibodies to HIV-1 and HIV-2 in human bloodā€¦Specificity is based on assay of blood donations from random donors [under the assumption that any positive result would be a false positive, yet when this test is used under normal circumstances such a positive would be treated as a true positive]ā€¦Specificity based on an assumed zero prevalence of antibody to HIV-1 and/or HIV-2 in random donors (17037 out of 17054) is estimated to be 99.90%ā€¦[but] in these calculations, one sample of the eighteen total repeatedly reactive specimens was confirmed by Western Blot and has been excluded.ā€

Human immunodeficiency virus types 1 and 2: (E. coli, B. megaterium, recombinant antigen) HIVAB HIV-1/HIV-2 (rDNA) EIA. Abbott Laboratories. 2004
http://davidcrowe.ca/SciHe

althEnv/papers/5017-Abbott

-EIA.pdf
ā€œA reactive result by Uni-Gold Recombigen HIV [test] suggests the presence of anti-HIV-1 antibodies in the specimen. Uni-Gold Recombigen HIV is intended as an aid in the diagnosis of infection with HIV-1. AIDS and AIDS-related conditions are clinical symptoms and their diagnosis can only be established clinically.ā€

Uni-Gold Recombigen HIV label. Trinity biotech. 2004 Jan
http://davidcrowe.ca/SciHe

althEnv/papers/3154-UniGol

dRapid.pdf
ā€œUni-Goldā„¢ RecombigenĀ® HIV is a single use rapid test, for the detection of antibodies to HIV-1 in plasma, serum and whole blood (venipuncture). Uni-Goldā„¢ RecombigenĀ® HIV is intended for use in point of care settings as an aid in diagnosis of infection with HIV-1ā€¦Immunosuppressed or immunocompromised indiv iduals infected with HIV-1 may not produce antibodies to the virusā€¦A Reactive result by Uni-Gold RecombigenĀ® HIV suggests[!] the presence of anti-HIV- 1 antibodies in the specimen. Uni-Gold RecombigenĀ® HIV is intended as an aid in the diagnosis of infection with HIV-1. AIDS and AIDS-related conditions are clinical symptoms and their diagnosis can only be established clinicallyā€¦ā€

Uni-Gold Recombigen HIV Control: Summary of safety and effectiveness. Trinity biotech. 2003 Dec http://davidcrowe.ca/SciHe

althEnv/papers/3156-UniGol

dSafetyEff.pdf
ā€œThe overall specificity of the Revealā„¢ Rapid HIV -1 Antibody Test for serum specimens in these studies was calculated to be 3608/3639 = 99.1%, combining the number of Revealā„¢ Rapid HIV -1 Antibody Test Non-Reactive results obtained from the study of previously screened HIV -1 antibody negative serum specimens with the number of Revealā„¢ Rapid HIV-1 Antibody Test Non-Reactive results obtained from the studies of high-risk populations [i.e. 1% false positives if we can assume that other antibody tests (ELISA and Western Blot) are 100% accurate and also completely independent from this rapid test]ā€¦The overall specificity of the Revealā„¢ Rapid HIV -1 Antibody Test for plasma [i.e. blood] specimens in these studies was calculated to be 2970/3011 = 98.6% [i.e. 1.4% of tests false positive] combining the number of Revealā„¢ Rapid HIV -1 Antibody Test Non-Reactive results obtained from the study of previously screened HIV -1 antibody negative plasma specimens with the number of Revealā„¢ Non-Reactive results obtained from the studies of low -risk populations [with the same caveats]ā€¦LIMITATIONS OF THE TESTā€¦6. Limited studies were conducted to determine the potential effect of interfering substances and unrelated medical conditions on the performance of the Revealā„¢ Rapid HIV -1 Antibody Test. 7. The specificity of the Revealā„¢ Rapid HIV -1 Antibody Test for serum specimens in low -risk populations has not been evaluated. 8. Limited studies were conducted to determine the performance of the Revealā„¢ Rapid HIV -1 Antibody Test on fresh serum and plasma specimens. 9. A Reactive test result using the Revealā„¢ Rapid HIV -1 Antibody Test suggests the presence of anti-HIV-1 antibodies in the specimen. The Revealā„¢ Rapid HIV -1 Antibody Test is intended to be used as an aid in the diagnosis of infection with HIV -1. AIDS and AIDS-related conditions are clinical syndromes and their diagnosis can only be established clinically. Results of the MedMira Revealā„¢ Rapid HIV -1 Antibody Test should not be used in isolation, but in conjunction with the clinical status, history, and risk factors of the individual being tested. 10. The intensity of the red dot (Reactive test result) does not necessarily correlate with the antibody titre [amount] of the specimen.ā€
Reveal rapid HIV-1 antibody test. MedMira. 2003 Dec 4
http://www.fda.gov/cber/pm

alabel/P000023LB.pdf

ā€œThe VERSANT HIV-1 RNA 3.0 Assay (bDNA) is not intended for use as a screening assay for HIV infection or as a diagnostic test to confirm the diagnosis of HIV infectionā€
Summary of Safety and Effectiveness - Versant HIV-1 RNA 3.0 Assay. Versant. 2003 Jul 9 http://davidcrowe.ca/SciHe

althEnv/papers/3152-Versan

tRNA.pdf

ā€œnonspecific reactions may occasionally be seen in specimens from people who have prior pregnancy, blood transfusion, or exposure to human cells or media containing cultured HIV antigen. Because of these and other potential nonspecific reactions, specimens reactive with the Vironostika HIV-1 Plus O Microelisa System assay should be confirmed with a confirmatory test ,e.g., Western Blot testingā€¦antibody. In individuals at increased risk of infection, such as homosexual men, hemophiliacs, or intravenous drug users, repeatedly reactive specimens are usually found to contain antibodies to HIV by additional, more specific tests. However, when the ELISA is used to screen populations with a low prevalence of HIV infections, nonspecific reactions may be more common than specific reactionā€¦Specimens found repeatedly reactive by ELISA and positive by additional, more specific tests are considered positive for antibodies to HIV-1. Clinical correlation is indicated with appropriate counseling, medical evaluation and possibly additional testing to decide whether a diagnosis of HIV infection is accurate.ā€
Vironostika HIV-1 plus O microelisa system. BiomƩrieux. 2003 Jun 5
http://davidcrowe.ca/SciHe

althEnv/papers/3150-Virono

stikaEIA.pdf

ā€œA Reactive result using the OraQuickĀ® Rapid HIV-1 Antibody Test suggests the presence of anti-HIV-1 antibodies in the specimen. The OraQuickĀ® Rapid HIV-1 Antibody Test is intended as an aid in the diagnosis of infection with HIV-1. AIDS and AIDS-related conditions are clinical syndromes and their diagnosis can only be established clinically. For a Reactive result, the intensity of the test line does not necessarily correlate with the titer of antibody in the specimen. A Non-Reactive result does not preclude the possibility of exposure to HIV or infection with HIV. An antibody response to recent exposure may take several months to reach detectable levels.ā€
Detection of HIV-1 antibodies in fingerstick whole blood specimens. OraSure. 2002 Nov 7
http://aras.ab.ca/articles

/corporate/OraQuickTestLab

el.pdf

ā€œThe ImmunoCombĀ® II HIV 1 & 2 BiSpot kit is a screening test. Reactivity for antibodies to HIV-1/HIV-2 must not be considered a diagnosis of Acquired Immunodeficiency Syndrome (AIDS) or of infection with HIV[!]. Since the production of antibodies to HIV may be delayed following initial exposure, non-reactivity with this test must not be considered conclusive evidence that the patient has not been exposed to or infected by HIVā€¦The following performance characteristics were calculated [on people of African origin] Sensitivityā€“100%; Specificityā€“98.4% [Meaning that when used in a low risk population with 1/1000 HIV infected there would be 1 true positive out of 1000 people and 6 false positives for a Positive Predictive Value of 14%]ā€
ImmunoComb II: HIV 1 & 2 BiSpot. Orgenics. 2002
http://www.orgenics.com/fi

les/pdf/60432002E-CE.pdf

ā€œLimitations: The ImmunoCombĀ® II HIV 1 & 2 CombFirm is a supplementary assay aimed at confirming the presence of antibodies to HIV antigens in initially reactive specimens. In the absence of uniformly accepted criteria for the interpretation of HIV antibody profiles, the above-described interpretation should be considered as a recommended guideline[!]. Yet, reactivity for antibodies to HIV-1/HIV-2 must not be considered a sole criterion for the diagnosis of Acquired Immunodeficiency Syndrome (AIDS) or of infection with HIV[!]. Since the production of antibodies may be delayed following initial exposure to HIV, or be suppressed due to the immunocompromised condition of a patient, a negative result with this test must not be considered conclusive evidence that the patient has not been exposed to or infected by HIV.ā€
ImmunoComb II: HIV 1 & 2 CombFirm. Orgenics. 2002
http://www.orgenics.com/fi

les/pdf/60434002E.pdf

ā€œThe NucliSens HIV-1 QT assay is not intended to be used as a screening test for HIV-1 nor is it to be used as a diagnostic test to confirm the presence of HIV-1 infection.ā€
NucliSens HIV-1 QT. Organon Teknika. 2001 Nov 13
http://davidcrowe.ca/SciHe

althEnv/papers/3153-NucliS

ens-NASBA.pdf

ā€œThe AMPLICOR HIV-1 MONITOR Test is an in vitro nucleic acid amplification test for the quantitation of Human Immunodeficiency Virus Type 1 (HIV-1) RNA in human plasma...[It] is not intended to be used as a screening test for HIV or as a diagnostic test to confirm the presence of HIV infectionā€¦Quantitative culture has limited utility for monitoring virus levels in infected individuals since only a small fraction of virus particles is infectious in vitro. Infectious virus is often undetectable in asymptomatic individualsā€¦The clinical specificity of theā€¦test was determined by analysis of 495 anti-HIV-1 negative blood donors. None of these specimens was reactiveā€¦Assuming[!] a zero prevalence of HIV-1 infection in the seronegative blood donors, the specificity of the test was 100%ā€
Amplicor HIV-1 Monitor Test. Roche. 1999
http://davidcrowe.ca/SciHe

althEnv/papers/379-Amplico

r.pdf

ā€œAlthough nonspecific reactvity [false positives] may sometimes be attributed to autoantibodies, it is possible that in some cases the pattern may represent a cross-reaction with another human retrovirus...POSITIVE blot results using any specimen type (serum, plama, or urine) should be followed with additional testing. Such testing may rely on alternative test methods or specimen types. [yet this is a 'confirmatory test'!]...[Table P shows that 1 out of 63 tests on pregnant women who were HIV ELISA negative was positive on western blot]

[Table A of this test kit label shows that 168 out of 364 people (75%) classified as low risk had at least one of 8 bands positive, but only 126 people were eventually classified as positive. Out of the 75% with at least one positive band only 54% had a p17 band while 79% had gp120/160. Amongst people with AIDS while 100% had a gp41 band and 98% had a gp120/160 band, only 21% had p17 and only 42% had p55]

[Table B of this test kit label shows that of 278 Low Risk people with a positive ELISA antibody test, 123 had negative Western Blots (44%), 29 indeterminate (11%) and 126 positive (45%). Of 86 people classified as low risk with consistently negative ELISA tests 73 (85%) were western blot negative, 13 (15%) were indeterminate and 0 were positive.]

Persons demonstrating antibodies to HIV-1 should be referred for medical evaluation, which may include testing by other techniques...Accurate diagnosis of HIV-1 infection is important in determining an individualā€™s risk for developing AIDS. Accuracy is complicated by false-positive and false-negative (EIA) results...Slight ambiguities exist in the designation of the molecular weights of the HIV-1 antigens [used in this test]...Although a [Western] blot POSITIVE for antibodies to HIV-1 indicates infection with the virus, a diagnosis of Acquired Immundeficiency Syndrome or AIDS can only be made clinically if a person meets the case definition of AIDS established by the CDC. POSITIVE blot results using any specimen type (serum, plasma, or urine) should be followed with additional testing [even though the Western Blot test is usually claimed to be a 'confirmatory' test]...The clinical implications of antibodies to HIV-1 in an asymptomatic person are not known. However, a larger proportion of such persons have virus detectable in their peripheral blood and some will develop immunodeficiency. INDETERMINATE blots should not be used as the basis for diagnosis of HIV-1 infection...A negative blot does not exclude the possibility of infection with HIV-1.ā€
Human Immundeficiency Virus type 1 (HIV-1) Western Blot kit. Cambridge Biotech. 1998 Jun 2
http://davidcrowe.ca/SciHe

althEnv/papers/3149-Cambri

dgeHIVUrine.pdf
ā€œIn order to afford maximum protection of the blood supply, the Genetic Systems rLAV EIA [ELISA] was designed to be extremely sensitive. As a result, non-specific reactions may be seen in samples form some people who, due to prior pregnancy, blood transfusion, or other exposure, have antibodies to the human cells or media in which the HIV-1 virus used for the manufacture of the Genetic Systems rLAV EIA is grownā€¦when the EIA is used to screen population in which the prevalence of infection with HIV-1 is low (e.g., blood donors), nonspecific reactions may be more common.ā€
Summary basis of approval: Genetic Systems rLAV EIA. Genetic Systems. 1998 Mar
http://davidcrowe.ca/SciHe

althEnv/papers/3151-GenSys

EIA.pdf
ā€œ"both the degree of risk for HIV-1 infection of the person studied and the degree of reactivity of the serum may be of value in interpreting the test"

"the EIA [this test] was designed to be extremely sensitive. As a result, non-specific reactions may be seen in samples from some people who, for example, due to prior pregnancy, blood transfusion, or other exposure, have antibodies to the human cells or media in which the HIV-1 is grown for manufacturer of the EIA. The risk of an asymptomatic person with a repeatably reactive serum sample developing AIDS or an AIDS-related condition is not known."

"At present there is no recognized standard for establishing the presence and absence of HIV-1 antibody in human blood."ā€
Human Immunodeficiency Virus Type 1 HIVAB HIV-1 EIA. Abbott Laboratories. 1997 Jan
http://davidcrowe.ca/SciHe

althEnv/papers/377-AbbottE

IA.pdf
ā€œNot all persons infected with HIV-1 will test positive; not all persons testing positive are infected with HIV-1ā€¦inaccurate results may occur and a positive test result alone does not mean I have AIDS or will ever develop AIDSā€¦an indeterminate result means the result is neither negative nor positiveā€

Home access HIV-1 test system. Home Access Health Corp.. 1996 May
http://davidcrowe.ca/SciHe

althEnv/papers/4825-HomeAc

cessHIVTest.pdf
ā€œThe possibility of exposure to or infection with HIV cannot be excluded by a negative [Coulter HIV-1 antigen] test result.ā€

Antibody to Human Immunodeficiency Virus type 1 (human); HIV-1 p24 antigen neutralization kit. Coulter. 1996 Apr
http://davidcrowe.ca/SciHe

althEnv/papers/2403-Coulte

r-p24.pdf

ā€œAIDS and AIDS-related conditions are syndromes that can only be established by clinical diagnosisā€¦The possibility of exposure to or infection with HIV cannot be excluded by a negative [Coulter HIV-1 antigen] test resultā€¦False positive results may occur due to non-specific binding to assay materials and not from infection with HIV-1ā€¦Based on an assumed 100% prevalence [of HIV] in antibody positive individuals, the sensitivity of the neutralization test was 99.5% (855/859) for repeatedly reactive specimens with a valid neutralization test and 100% (855/855) for specimens that were stored and tested according to recommendations.ā€

Antibody to Human Immunodeficiency Virus type 1 (human); HIV-1 p24 antigen neutralization kit. Coulter. 1996 Apr
http://davidcrowe.ca/SciHe

althEnv/papers/2403-Coulte

r-p24.pdf

ā€œHIV-1 p24 antigen is present only transiently prior to seroconversion and later can be complexed by specific antibodies. HIV-1 p24 antigen testing should not be used in lieu of HIV-1 antibody testing as a screen for HIV-1 infectionā€¦The predictive value of a positive test is strongly influenced by the prevalence of HIV-1 infection in the population tested. For example, in low prevalence populations the predictive value was 11.1% (1/9) while in populations with known HIV-1 infection, the predictive value was 97.1% (395/407).ā€
Antibody to Human Immunodeficiency Virus type 1; HIVAG-1 Monoclonal. Abbott Laboratories. 1996 Apr
http://davidcrowe.ca/SciHe

althEnv/papers/2402-Abbott

Antigen.pdf
ā€œFalse positive results [with this HIV-1 antigen test kit] may occur due to non-specific binding to assay materials, and not from infection with HIV-1ā€
Antibody to Human Immunodeficiency Virus type 1 p24 antigen (murine monoclonal). Coulter. 1996 Apr
http://davidcrowe.ca/SciHe

althEnv/papers/2404-Coulte

r-p24-Murine.pdf
ā€œWhen the EIA [enzyme immunoassay antibody test] is used to screen populations in which the prevalence of HIV-1 infection is low (e.g., blood donors), nonspecific reactions may be more commonā€¦Reactivity at only slightly above the cut-off value is more frequently nonspecificā€¦A person who has antibodies to HIV-1 is presumed to be infected with the virusā€¦The risk of an asymptomatic person with a repeatedly reactive serum sample developing AIDS or an AIDS-defining condition is not known.ā€
Human immunodeficiency virus type 1 HIVAB HIV-1 EIA. Abbott Laboratories. 1993
http://davidcrowe.ca/SciHe

althEnv/papers/4188-Abbott

EIA_1993.pdf

ā€œIn comparison with antibody testing, antigen testing will only detect approximately 50% of AIDS, 30% of ARC [AIDS Related Complex] and 10% of asymptomatic HIV infectionsā€¦the predictive value of a positive test is strongly influenced by the prevalence of the condition in the population tested. In low risk populations, where the rate of HIV-1 infection may not exceed 0.1%, the rate of antigen positivity could be as low as 0.01%. Assuming a test sensitivity of 100%, the positive predictive value of a repeatably reactive test would be only 5.9%, i.e. only 6 tests per 100 would be true positivesā€¦The sensitivity and specificity of the HIVAG-1 blocking antibody procedure are not knownā€¦In clinical studies performed in low risk populations, the neutralization test was negative for 137/137 repeatedly reactive (presumed false reactive) samples giving a 95% confidence range for specificity of 97.8% to 100%ā€¦in known infected individuals [assuming the accuracy of antibody tests], the HIVAG-1 blocking antibody test was positive in 67/67 repeatedly reactive (presumed true positive) samples giving a 95% confidence range for sensitivity of 95.9% to 100%ā€

HIVAG-1; Antibody to Human Immunodeficiency Virus Type 1. Abbott Laboratories. 1989
http://davidcrowe.ca/SciHe

althEnv/papers/2401-Abbott

Antibody.pdf
ā€œManufacturers claim impressive levels of accuracy [of HIV tests] - usually well in excess of 99% - but much depends on the context in which the assays are being used, and any overall figure is likely to be misleading.ā€
Mortimer PP. The AIDS virus and the HIV test. Med Int. 1988;56:2334-9.
ā€œClinical samples have also been described haveā€¦been described that are reactive in the screening assays but do not contain HIV-1 antibody. Some of these samples possess antibody to certain Class II HLA histocompatibility antigens that are found in some cell lines used to produce the virus. Other persons, who have had no known exposure to HIV-1, produce reactive results in the screening test for still unknown reasons. Such nonspecific results are found commonly when screening tests are used in large populations. Since the psychosocial and medical implications of a positive antibody test may be devastating, it has been recommended that additional testing be performed on such samples [such as this test]ā€¦A sample that is reactive in both the EIA screening test and the Western blot is presumed [!] to be positive for antibody to HIV-1, indicating infection with this virus except in situations of passively acquired antibody or experimental vaccinationā€¦Sensitivity and specificity of the HIV-1 Western Blot Kit was determined in comparative studies with a previously licensed HIV-1 Western blot using EIA repeatedly reactive samples from high AIDS risk and low risk populations respectively [i.e. without a ā€˜gold standardā€™ such as virus purification] [Specificity can only be tested with EIA negative specimens, of which there were none].ā€
Human Immunodeficiency Virus Type 1 (HIV-1) HIV-1 Western Blot Kit. Epitope.
http://davidcrowe.ca/SciHe

Komentarji ā€¢ 3

če želiŔ komentirati, se
rayandexter
rayandexter ā€¢ 4 mesece nazaj

What kind of tests are to be performed additionally? Working on a research at http://essaywriting.center and lack some significant data.

rikisuave
rikisuave ā€¢ 6 let nazaj

My last visit at tests: I can't get HIV or Hepatitis B.My body cannot recognize the virus! Hmm...

VpiŔi email osebe, ki ji želiŔ priporočiti ogled bloga.




stalna povezava



Za nadaljevanje se prijavi

Za prijavo uporabi Facebook

Facebook prijava

Za prijavo uporabi geslo

Samodejna prijava



pozabljeno geslo ā€¢ včlanitev