First ELISA rective, CMIA and ELISA non-reactive

Question

Dear Doctor,

I have a quick question for you. My husband was recently summoned by a blood bank who were doing a routine screening test and found his ELISA results were reactive for HIV I & II. They did not run a repeat ELISA or western blot to confirm the results. Needless to say the remaining days we spent were extremely stressful, and we went for three tests and two different labs. The first lab ran an immunochromatography, and a 4th generation ELISA and they both came out non-reactive. The second lab ran a CMIA and it came out non-reactive.

Considering the fact that my husband has only me as his sexual partner, (and I tested negative three months back) and an almost no-risk exposure, unless we consider one instance where he got himself a razor cut 4 months back in a saloon, should we treat these non-reactive results as a final negative status? Or, should we got for a western blot too?

FYI: We are based out of India. The blood donation happened in mid-may, and all the tests other than the one which showed false-positive, happened a month later in mid-june.

Answer

Hi,

Your husband is definitively and conclusively HIV negative! Please note the type of HIV testing performed at blood banks is done to protect the blood supply, not diagnose HIV disease. The blood bank tests are set to be very sensitive so as not to miss any true HIV infections. Because of this degree of sensitivity, the tests can (and do) generate some "false positive" tests. This is what happened with your husband as confirmed by his subsequent negative HIV tests. No further HIV testing is warranted. Read through the information in the archives of this forum. We have a chapter devoted to blood donations. You should find the information there reassuring.

Dr. Bob