Asymptomatic blood donor with a false positive HTLV-III Western blot.
Asymptomatic blood donor with a false positive HTLV-III Western blot.
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HTLV-III 蛋白质印迹假阳性的无症状献血者。
DOI：
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发表时间：
1986
影响因子：
158.5
通讯作者：
J. Britz
中科院分区：
文献类型：
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作者：
M. Saag;J. Britz
这封信描述了一个无症状献血者的人类 T 淋巴细胞病毒 III 型 (HTLV-III) 抗体蛋白质印迹检测呈假阳性的案例。该患者是一位来自阿拉巴马州农村的 34 岁女性，于 1985 年献血，5 次重复酶联免疫吸附测定 (ELISA) 和 1 次蛋白质印迹检测结果呈阳性。临床评估显示，该患者没有症状，体检结果正常。她的 T4:T8 比例为 2.1:1，淋巴细胞计数正常。她的丈夫和儿子的 ELISA 抗体呈阴性。患者及其丈夫均否认有任何同性恋、婚外性行为、静脉注射吸毒、输血或出国旅行等情况。从患者身上抽取了更多血液并送往 3 个实验室进行进一步检测。蛋白质印迹放射免疫沉淀和病毒分离研究均为阴性。随后在 2 个实验室再次重复 ELISA，结果呈阳性。然而，当使用控制与 H9 细胞材料的非特异性反应的未经许可的程序时，在对照板上也注意到强烈的反应性。对该样品进行 HTLV-III 间接荧光抗体测试的进一步测试未能证明 HTLV-III 特异性血清典型的大细胞荧光模式，但在患者血清中发现了抗线粒体抗体。血清中这些抗体以及核抗原、人类白细胞抗原和人类 T 细胞抗原的抗体的存在与 ELISA 的错误反应相关。当患者出现阴性临床病史和阳性血清学检测时，应强烈考虑假阳性检测结果的可能性。需要改进确认性测试以及获得这些测试的机会。
This letter describes a case of a false positive Western blot test for antibodies to human T-lymphotropic virus type III (HTLV-III) in an asymptomatic blood donor. 5 repeat enzyme-linked immunosorbent assays (ELISAs) and 1 Western blot provided positive results in this patient a 34-year old woman from rural Alabama who donated blood in 1985. On clinical evaluation the patient was asymptomatic and her physical examination was normal. Her T4:T8 ratio was 2.1:1 with a normal lymphocyte count. Her husband and son were antibody negative by ELISA. Both the patient and her husband denied any homosexual extramarital sexual encounters intravenous drug abuse blood transfusions or foreign travel. More blood was drawn from the patient and sent to 3 laboratories for further testing. Western blot radioimmunoprecipitation and virus isolation studies were all negative. ELISAs were then repeated in 2 laboratories again with positive results. However when an unlicensed procedure that controls for nonspecific reactions with H9 cellular material was used strong reactivity was also noted on the control plate. Further testing of this sample on an indirect fluorescent antibody test for HTLV-III failed to demonstrate the large cell fluorescent pattern typical of HTLV-III-specific serum but identified antimitochondrial antibodies in the patients serum. The presence of these antibodies in serum as well as antibodies to nuclear antigens human leukocyte antigens and human T-cell antigens has been correlated with false reactivity on ELISAs. When patients present with negative clinical histories and positive serologic tests the possibility of false positive test results should be strongly considered. Needed are improved confirmatory tests as well as access to these tests.