Absence of HIV infection in blood donors with indeterminate Western blot tests for antibody to HIV-1

J. Brooks Jackson, Kristine L. Macdonald, Jane Cadwell, Carolyn Sullivan, William E. Kline, Margaret Hanson, Kim J. Sannerud, Susan L. Stramer, Nicola J. Fildes, Shirley Y. Kwok, John J. Sninsky, Robert J. Bowman, Herbert F. Polesky, Henry H. Balfour, Michael T. Osterholm

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111 Scopus citations


To determine whether apparently healthy persons who have had repeatedly reactive enzyme immunoassays and an indeterminate Western blot assay for antibody to the human immunodeficiency virus type 1 (HIV-1) are infected with HIV-1 or HIV-2, we studied 99 such volunteer blood donors in a low-risk area of the country. The subjects were interviewed about HIV risk factors. Coded blood specimens were tested again for HIV-1 antibody (by two different enzyme immunoassays, a Western blot assay and a radioimmunoprecipitation assay) and for HIV-2 antibody by enzyme immunoassay, for HIV-1 by the serum antigen test, for HIV-1 by culture, for human T-cell leukemia virus Type I or II antibody by enzyme immunoassay, and for sequences of HIV DNA by the polymerase chain reaction. Of the 99 blood donors, 98 reported no risk factors for HIV-1 infection; 1 donor had used intravenous drugs. After a median of 14 months (range, 1 to 30) from the time of the initial test, 65 subjects (66 percent) were still repeatedly reactive for HIV-1 antibody on at least one immunoassay. In 91 subjects (92 percent) the Western blot results were still indeterminate, whereas in 8 they were negative. No donor met the criteria for a positive Western blot assay for HIV-1, and none had evidence of HIV-1 or HIV-2 infection on culture or by any other test. We conclude that persons at low risk for HIV infection who have persistent indeterminate HIV-1 Western blots are rarely if ever infected with HIV-1 or HIV-2.

Original languageEnglish (US)
Pages (from-to)217-222
Number of pages6
JournalNew England Journal of Medicine
Issue number4
StatePublished - Jan 25 1990
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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