Letter to the Editor Vox Sang 1992;63:234-235
I? Cavulli A . Pennacchio G. L. Romanini Servizio Immunotrasfusionale Ospedale di Cremona, ltalia
Whole Virus Lysate or Recombinant Synthetic ELSA Assay to HIV-1: Which Is Better?
Blood donors with persistent and isolated core antibodies to HIV-1 (anti-p24 or antip17) on Western blot (WB) are not at risk of HIV-1 infection, as suggested by others using the polymerase chain reaction follow-up of recipients and virus culture [l-31. Nevertheless, the presence of anti-p24 alone on WB should not be regarded as a false-positive result. In fact, 3.7-4.3% GAGonly indeterminate WB blood donors may develop additional bands on WB [4,5]. More than 1case of later seroconversion to HIV-1 has been reported in blood donors with a positive reaction in the HIV lysate ELISA and anti-p24 only on Western blot [5,6]. So, it is still prudent to continue to exclude blood units which are ELISA positive and WB indeterminate, to follow up these donors and demonstrate evidence of riskfactors. However, demonstration of high-risk behaviour in these individuals may not be sufficient a s HIV-1 risk factors have changed. ELISA anti-HIV-1 assaysbased on whole virus lysate recognize these atypical samples better than ELISA assays based on recombinant antigens and/or synthetic proteins, as shown by our data. Eighty-six blood samples were tested on WB (Pasteur Diagnostics, France) and on five HIV-1 antibody assays, using one ELISA assay based on proteins from virus culture (ELAVIA, Pasteur) and four ELISA assays based on recombinant proteins or synthetic peptides (Wellcome, Ortho, Pasteur, Behring). On 30 samples, obtained from previously studied drug addicts (positive controls), we found a WB positivity (all bands) and a 100%
Dr. P. Cavalli. MD Servizio lmmunotrasfusionale Ospedale di Cremona 1-26100 Cremona (Italy)
positive correlation among all the ELISA assays used. On 25 samples, obtained from healthy blooddonors (negative controls), we found no detectable band on WB and a 100% negative correlation among the five ELISA assays used. On 31 samples, obtained from blood donors with an indeterminate WB pattern, we found 64.5% (20/31) to be ELAVIA assay positive (1.5
I? Cavulli A . Pennacchio G. L. Romanini Servizio Immunotrasfusionale Ospedale di Cremona, ltalia
Whole Virus Lysate or Recombinant Synthetic ELSA Assay to HIV-1: Which Is Better?
Blood donors with persistent and isolated core antibodies to HIV-1 (anti-p24 or antip17) on Western blot (WB) are not at risk of HIV-1 infection, as suggested by others using the polymerase chain reaction follow-up of recipients and virus culture [l-31. Nevertheless, the presence of anti-p24 alone on WB should not be regarded as a false-positive result. In fact, 3.7-4.3% GAGonly indeterminate WB blood donors may develop additional bands on WB [4,5]. More than 1case of later seroconversion to HIV-1 has been reported in blood donors with a positive reaction in the HIV lysate ELISA and anti-p24 only on Western blot [5,6]. So, it is still prudent to continue to exclude blood units which are ELISA positive and WB indeterminate, to follow up these donors and demonstrate evidence of riskfactors. However, demonstration of high-risk behaviour in these individuals may not be sufficient a s HIV-1 risk factors have changed. ELISA anti-HIV-1 assaysbased on whole virus lysate recognize these atypical samples better than ELISA assays based on recombinant antigens and/or synthetic proteins, as shown by our data. Eighty-six blood samples were tested on WB (Pasteur Diagnostics, France) and on five HIV-1 antibody assays, using one ELISA assay based on proteins from virus culture (ELAVIA, Pasteur) and four ELISA assays based on recombinant proteins or synthetic peptides (Wellcome, Ortho, Pasteur, Behring). On 30 samples, obtained from previously studied drug addicts (positive controls), we found a WB positivity (all bands) and a 100%
Dr. P. Cavalli. MD Servizio lmmunotrasfusionale Ospedale di Cremona 1-26100 Cremona (Italy)
positive correlation among all the ELISA assays used. On 25 samples, obtained from healthy blooddonors (negative controls), we found no detectable band on WB and a 100% negative correlation among the five ELISA assays used. On 31 samples, obtained from blood donors with an indeterminate WB pattern, we found 64.5% (20/31) to be ELAVIA assay positive (1.5
