Re: When "HIV antibodies" are not "HIV" antibodies 21 February 2005
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Peter Flegg,
Physician
Blackpool, UK, FY3 8NR

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Re: Re: When "HIV antibodies" are not "HIV" antibodies

The Perth group ask me: “How does a person develop “HIV-antibodies” apart from being infected with “HIV”?”.

To clarify matters for them, HIV antibodies are always induced by HIV infection. I am not claiming that a positive anti-HIV ELISA test is proof positive of HIV antibodies (and therefore HIV infection), it merely indicates a positive test.

The tests for HIV antibody are not 100% specific, since the assays used may rarely be reactive (positive) in the absence of specific HIV antibody. In the field of laboratory diagnostics this is what is known as a “false positive test”.

This is why a single positive HIV antibody test should not automatically be assumed to indicate an HIV diagnosis or infection.

They also ask: “When was the last time Peter Flegg told a patient of any description with “HIV-antibodies” he is not infected with “HIV”?”

I do encounter patients whose HIV antibody tests are falsely positive. The last occasion was about 6 months ago in a patient with acute hepatitis B, whose HIV screening test was reactive (but negative using confirmatory assays and negative 2 weeks later).

Perhaps I can ask the Perth group some questions in turn concerning the tests.

(1) Why do so many individuals whose lifestyles put them at risk for “oxidative stress” have negative HIV antibody tests?
(2) Why do these HIV-seronegative individuals not develop profound, clinically-relevant immunodeficiency?
(3) Why is it only those who are HIV seropositive who develop profound, clinically-relevant immunodeficiency?

Competing interests: None declared