WHOSE ANTIBODIES ARE THEY ANYWAY? Factors Known to Cause False Positive HIV Antibody Test Results

By Christine Johnson

Continuum Sept./Oct. 1996

The AIDS establishment has managed to convince many people that the HIV antibody tests (ELISA, IFA and Western blot) are "99.5% accurate". In this article Christine Johnson from HEAL Los Angeles, lists conditions documented in the scientific literature known to cause positives on these tests, and gives her references.

It is expected that this list will generate much discussion and dissension. For the time being, a few clarifications should be made at the outset.

Just because something is on the list doesn't mean that it will definitely, or even probably, cause a false-positive. It depends on what antibodies the individual carries; as well as the characteristics of each particular test kit.

For instance, some, but not all, people who have had blood transfusions, prior pregnancies or an organ transplant will make HLA antibodies. And some, but not all, test kits (both ELISA and Western blot) will be contaminated with HLA antigens to which these antibodies can react. Only if these two conditions coincide might you get a false-positive due to HLA cross-reactivity.

Some things are more likely than others to cause false-positives. And some things that we aren't aware of yet, but which may be documented in the future, may cause false-positives. Some of the factors on the list have been documented only for ELISA, some for both ELISA and Western blot (WB).

Some people may be eager to argue that if a factor is only known to cause false-positives on ELISA, this problem won't be carried over to the WB, so everything should be OK. But remember, a WB is positive by virtue of accumulating enough individual positive bands to add up to the total required by whatever criteria you use to interpret it (39) So the more exposures a person has had to foreign antigens, proteins and infectious agents, the more various antibodies he or she will have in their system, and the more likely it is that there will be several cross-reacting antibodies, enough to make the WB positive.

It is to be noted that all AIDS risk groups (and Africans as well), but not the general US or Western European population, have this problem in common: they have been exposed to a plethora of foreign antigens and proteins. This is why people in the AIDS "risk groups" tend to have positive WBs (i.e., to be considered "HIV-infected") and people in the general population don't. However, even people in the low-risk populations may have false-positive Western blots for poorly understood reasons.(47)

Since false-positives to every single HIV protein have been documented (36), how do you know the positive WB bands represent the various proteins to HIV, or just a collection of false-positive bands reacting to several different non-HIV antibodies?

Factors Known to Cause False-Positive HIV Antibody Test Results

• Anti-carbohydrate antibodies (52, 19, 13)
• Naturally-occurring antibodies (5, 19)
• Passive immunization: receipt of gamma globulin or immune globulin (as prophylaxis against infection which contains antibodies)(18, 26, 60, 4, 22, 42, 43, 13)
• Leprosy (2, 25)
• Tuberculosis (25)
• Mycobacterium avium (25)
• Systemic lupus erythematosus (15, 23)
• Renal (kidney) failure (48, 23, 13)
• Hemodialysis/renal failure (56, 16, 41, 10, 49)
• Alpha interferon therapy in hemodialysis patients (54)
• Flu (36)
• Flu vaccination (30, 11, 3, 20, 13, 43)
• Herpes simplex I (27)
• Herpes simplex II (11)
• Upper respiratory tract infection (cold or flu)(11)
• Recent viral infection or exposure to viral vaccines (11)
• Pregnancy in multiparous women (58, 53, 13, 43, 36)
• Malaria (6, 12)
• High levels of circulating immune complexes (6, 33)
• Hypergammaglobulinemia (high levels of antibodies) (40, 33)
• False positives on other tests, including RPR (rapid plasma reagent) test for syphilis (17, 48, 33, 10, 49)
• Rheumatoid arthritis (36)
• Hepatitis B vaccination (28, 21, 40, 43)
• Tetanus vaccination (40)
• Organ transplantation (1, 36)
• Renal transplantation (35, 9, 48, 13, 56)
• Anti-lymphocyte antibodies (56, 31)
• Anti-collagen antibodies (found in gay men, haemophiliacs, Africans of both sexes and people with leprosy)(31)
• Serum-positive for rheumatoid factor, antinuclear antibody (both found in rheumatoid arthritis and other autoantibodies)(14, 62, 53)
• Autoimmune diseases (44, 29, 10, 40, 49, 43): Systemic lupus erythematosus, scleroderma, connective tissue disease, dermatomyositis
• Acute viral infections, DNA viral infections (59, 48, 43, 53, 40, 13)
• Malignant neoplasms (cancers)(40)
• Alcoholic hepatitis/alcoholic liver disease (32, 48, 40,10,13, 49, 43, 53)
• Primary sclerosing cholangitis (48, 53)
• Hepatitis (54)
• "Sticky" blood (in Africans) (38, 34, 40)
• Antibodies with a high affinity for polystyrene (used in the test kits)(62, 40, 3)
• Blood transfusions, multiple blood transfusions (63, 36,13, 49, 43, 41)
• Multiple myeloma (10, 43, 53)
• HLA antibodies (to Class I and II leukocyte antigens)(7, 46, 63, 48, 10, 13, 49, 43, 53)
• Anti-smooth muscle antibody (48)
• Anti-parietal cell antibody (48)
• Anti-hepatitis A IgM (antibody)(48)
• Anti-Hbc IgM (48)
• Administration of human immunoglobulin preparations pooled before 1985 (10)
• Haemophilia (10, 49)
• Haematologic malignant disorders/lymphoma (43, 53, 9, 48, 13)
• Primary biliary cirrhosis (43, 53, 13, 48)
• Stevens-Johnson syndrome9, (48, 13)
• Q-fever with associated hepatitis (61)
• Heat-treated specimens (51, 57, 24, 49, 48)
• Lipemic serum (blood with high levels of fat or lipids)(49)
• Haemolyzed serum (blood where haemoglobin is separated from the red cells)(49)
• Hyperbilirubinemia (10, 13)
• Globulins produced during polyclonal gammopathies (which are seen in AIDS risk groups)(10, 13, 48)
• Healthy individuals as a result of poorly-understood cross-reactions (10)
• Normal human ribonucleoproteins (48,13)
• Other retroviruses (8, 55, 14, 48, 13)
• Anti-mitochondrial antibodies (48, 13)
• Anti-nuclear antibodies (48, 13, 53)
• Anti-microsomal antibodies (34)
• T-cell leukocyte antigen antibodies (48, 13)
• Proteins on the filter paper (13)
• Epstein-Barr virus (37)
• Visceral leishmaniasis (45)
• Receptive anal sex (39, 64)

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