Medical Forum / Diseases and Disorders / AIDS / May 2005
Factors Known to Cause False Positive HIV Antibody Test Results
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PaulKing - 07 May 2005 22:42 GMT Factors Known to Cause False Positive HIV Antibody Test Results
1.Anti-carbohydrate antibodies 52,19,13 2.Naturally-occurring antibodies 5,19 3.Passive immunization: receipt of gamma globulin or immune (as prophylaxis against infection which contains antibodies) 18, 26, 60, 4, 22, 42, 43, 13 4.Leprosy 2, 25 5.Tuberculosis 25 6.Mycobacterium avium 25 7.Systemic lupus erythematosus 15, 23 8.Renal (kidney) failure 48, 23, 13 9.Hemodialysis/renal failure 56, 16, 41, 10, 49 10.Alpha interferon therapy in hemodialysis patients 54 11.Flu 36 12.Flu vaccination 30, 11, 3, 20, 13, 43 13.Herpes simplex I 27 14.Herpes simplex II 11 15.Upper respiratory tract infection (cold or flu) 11 16.Recent viral infection or exposure to viral vaccines 11 17.Pregnancy in multiparous women 58, 53, 13, 43, 36 18.Malaria 6, 12 19.High levels of circulating immune complexes 6, 33 20.Hypergammaglobulinemia (high levels of antibodies) 40, 33 21.False positives on other tests, including RPR (rapid plasma reagent) test for syphilis 17, 48, 33, 10, 49 22.Rheumatoid arthritis 36 23.Hepatitis B vaccination 28, 21, 40, 43 24.Tetanus vaccination 40 25.Organ transplantation 1, 36 26.Renal transplantation 35, 9, 48, 13, 56 27.Anti-lymphocyte antibodies 56, 31 28.Anti-collagen antibodies (found in gay men, haemophiliacs, Africans of both sexes and people with leprosy) 31 29.Serum-positive for rheumatoid factor, antinuclear antibody (both found in rheumatoid arthritis and other autoantibodies) 14, 62, 53 30.Autoimmune diseases 44, 29, 1O, 40, 49, 43 31.Systemic lupus erythematosus, scleroderma, connective tissue disease, dermatomyositis Acute viral infections, DNA viral infections 59, 48, 43, 53, 40, 13 32.Malignant neoplasms (cancers) 40 33.Alcoholic hepatitis/alcoholic liver disease 32, 48, 40, 10, 13, 49, 43, 53 34.Primary sclerosing cholangitis 48, 53 35.Hepatitis 54 36."Sticky" blood (in Africans) 38, 34, 40 37.Antibodies with a high affinity for polystyrene (used in the test kits) 62, 40, 3 38.Blood transfusions, multiple blood transfusions 63, 36, 13, 49, 43, 41
39.Multiple myeloma 10, 43, 53 40.HLA antibodies (to Class I and II leukocyte antigens) 7, 46, 63, 48, 10, 13, 49, 43, 53 41.Anti-smooth muscle antibody 48 42.Anti-parietal cell antibody 48 43.Anti-hepatitis A IgM (antibody) 48 44.Anti-Hbc IgM 48 45.Administration of human immunoglobulin preparations pooled before 1985 10 46.Haemophilia 10, 49 47.Haematologic malignant disorders/lymphoma 43, 53, 9, 48, 13 48.Primary biliary cirrhosis 43, 53, 13, 48 49.Stevens-Johnson syndrome 9, 48, 13 50.Q-fever with associated hepatitis 61 51.Heat-treated specimens 51, 57, 24, 49, 48 52.Lipemic serum (blood with high levels of fat or lipids) 49 53.Haemolyzed serum (blood where haemoglobin is separated from red cells) 49 54.Hyperbilirubinemia 10, 13 55.Globulins produced during polyclonal gammopathies (which are seen in AIDS risk groups) 10, 13, 48 cross-reactions 10 57.Normal human ribonucleoproteins 48, 13 58.Other retroviruses 8, 55, 14, 48, 13 59.Anti-mitochondrial antibodies 48, 13 60.Anti-nuclear antibodies 48, 13, 53 61.Anti-microsomal antibodies 34 62.T-cell leukocyte antigen antibodies 48, 13 63.Proteins on the filter paper 13 64.Epstein-Barr virus 37 65.Visceral leishmaniasis 45 66.Receptive anal sex 39, 64 Christine Johnson, a researcher and author, compiled this list of conditions documented in the scientific literature to cause positives on HIV tests, and provides references for each condition. Christine notes: "Just because something is on this 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. There are conditions that are more likely than others to cause false-positives. And there are some conditions that we aren't aware of yet which may be documented in the future to cause false-positives. Some of the factors on the list have been documented only for ELISA, while some have been documented for both ELISA and Western blot (WB) tests. 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. But remember, a WB is positive by virtue of accumulating enough individual positive bands to add up to the total required by whatever criteria is used to interpret it 39. So the more exposure 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 population don't. However, even people in low-risk populations have false-positive Western blots for poorly understood reasons 47. Since false-positives to every single HIV protein have been documented 36, how do we know if the positive WB bands represent the various proteins to HIV, or a collection of false-positive bands reacting to several different non-HIV antibodies?"
GMCarter - 08 May 2005 11:38 GMT >Factors Known to Cause >False Positive HIV Antibody Test Results This was reviewed and found to be riddled with errors and nonsense. You do not cite the original source, of course, which is from 1996. Repeatedly cited, repeatedly refuted. Repeatedly reposted by Mark without EVER being able to comment on the extensive refutations.
Not to say that some conditions won't cause a false positive. This happens with EVERY diagnostic test. ALL of them. And HIV tests have a high specificity and sensitivity.
George M. Carter
PaulKing - 09 May 2005 06:59 GMT "This was reviewed"
What utter nonsense. Who reviewed it?
You?
tsip29 - 09 May 2005 20:20 GMT hi, paul
who reviewed the list you are giving! can you also direct me to studys that shows this !
also you have heard most of what is out there! can you tell me of studies that have been done by dutch( =netherlands) resaerchers about hiv/aids.
PaulKing - 09 May 2005 07:00 GMT "And HIV tests have a high specificity and sensitivity."
You know that is a COMPLETE lie.
David Canzi -- non-mailable - 09 May 2005 22:21 GMT >"And HIV tests have a >high specificity and sensitivity." > >You know that is a COMPLETE lie. http://www.randi.org/research/index.html
 Signature David Canzi
PaulKing - 09 May 2005 22:50 GMT Your paranormal site link.
Well, if you believe in 'AIDS' I should have known you would believe in the paranormal too.
You really do love nonsense.
David Canzi -- non-mailable - 10 May 2005 02:23 GMT >Your paranormal site link. Try reading enough of the site to find out what it's about.
Since you often claim to have telepathic powers, I thought you might be interested in Randi's challenge.
 Signature David Canzi
Gary Stein - 10 May 2005 02:49 GMT > In article > <472281b28ca963b278d5164f1bf145a5@localhost.talkabouthealthnetwork.com>, [quoted text clipped - 4 lines] > Since you often claim to have telepathic powers, I thought you might > be interested in Randi's challenge. Paul read....you've got to be joking he has a hard enough time cutting and pasting I doubt he spends much time actually reading. If he did he might realize that he's totally wrong on just about every point he tries to make.
Gary Stein
PaulKing - 10 May 2005 04:00 GMT "If he did he might realize that he's totally wrong on just about every point he tries to make."
Was that a typo? Did you mean 'every point you make?'
Yes I do see that you are a total idiot.
Thanks for making the point.
PaulKing - 10 May 2005 03:58 GMT "Since you often claim to have telepathic powers"
I have NEVER claimed any such thing. I don't believe in such nonsense.
Do you lie about everything?
David Canzi -- non-mailable - 10 May 2005 04:25 GMT >"Since you often claim to have telepathic powers" > >I have NEVER claimed any such thing. I don't believe in such nonsense. Here are three of your recent claims of telepathic power:
"You know the truth on this point"
"They are complete nonsense as you well know."
"You know that is a COMPLETE lie."
 Signature David Canzi
Alex - 10 May 2005 18:07 GMT > "And HIV tests have a > high specificity and sensitivity." > > You know that is a COMPLETE lie. And contradictory. Usually, specificity and sensitivity are inversely correlated (you have one at the detriment to the other - hence the use of [sensitive] screening tests and [specific] confirmation tests). Or so the theory goes.
Alex
GMCarter - 10 May 2005 22:23 GMT >> "And HIV tests have a >> high specificity and sensitivity." [quoted text clipped - 5 lines] >to the other - hence the use of [sensitive] screening tests >and [specific] confirmation tests). Or so the theory goes. I would be delighted to see where you got this idea!
Doesn't seem to suggest that here: http://www.cebm.utoronto.ca/glossary/spsn.htm
But it does go a way to explaining your typical statistical dithering.
George M. Carter
David Canzi -- non-mailable - 11 May 2005 04:32 GMT >>Usually, specificity and sensitivity >>are inversely correlated (you have one at the detriment [quoted text clipped - 7 lines] > >But it does go a way to explaining your typical statistical dithering. Alex is what's known as a "statistical outliar".
 Signature David Canzi
GMCarter - 11 May 2005 10:46 GMT snip...
>Alex is what's known as a "statistical outliar". <groan>
PaulKing - 11 May 2005 12:32 GMT Unreliable Tests
A September 2004, San Francisco Chronicle article considered the "beauty" of testing. It told the story of 59 year-old veteran Jim Malone, who'd been told in 1996 that he was HIV positive. His health was diagnosed as "very poor." He was classified as "permanently disabled and unable to work or participate in any stressful situation whatsoever."
In 2004, his doctor sent him a note to tell him he was actually negative. He had tested positive at one hospital, and negative at another.
Nobody asked why the second test was more accurate than the first (this was the protocol at the Veteran's Hospital). Having been falsely diagnosed and spending nearly a decade waiting, expecting to die, Malone said, "I would tell people to get not just one HIV test, but multiple tests. I would say test, test and retest."
In the article, AIDS experts assured the public that the story was "extraordinarily rare." But the medical literature differs significantly.
The Numbers
In 1985, at the beginning of HIV testing, it was known that "68% to 89% of all repeatedly reactive ELISA (HIV antibody) tests [were] likely to represent false positive results." (New England Journal of Medicine. 1985).
In 1992, the Lancet reported ("HIV Screening in Russia") that for 66 true positives, there were 30,000 false positives. And in pregnant women, "there were 8,000 false positives for 6 confirmations."
In September 2000, the Archives of Family Medicine stated that the more women we test, the greater "the proportion of false-positive and ambiguous (indeterminate) test results."
The tests described above are standard HIV tests, the kind promoted in the ads. Their technical name is ELISA or EIA (Enzyme-linked Immuno-sorbant Assay). They are antibody tests. The tests contain proteins that react with antibodies in your blood.
False Positives
In the U.S., you're tested with an ELISA first. If your blood reacts, you'll be tested again, with another ELISA. Why is the second more accurate than the first? That's just the protocol. If you have a reaction on the second ELISA, you'll be confirmed with a third antibody test, called the Western Blot. But that's here in America. In some countries, one ELISA is all you get.
It is precisely because HIV tests are antibody tests that they produce so many false-positive results. All antibodies tend to cross-react. We produce anti-bodies all the time, in response to stress, malnutrition, illness, drug use, vaccination, foods we eat, a cut, a cold, even pregnancy. These antibodies are known to make HIV tests come up as positive.
The medical literature lists dozens of reasons for positive HIV test results: "transfusions, transplantation, or pregnancy, autoimmune disorders, malignancies, alcoholic liver disease, or for reasons that are unclear..." (Archives of Family Medicine. Sept/Oct. 2000).
"[L]iver diseases, parenteral substance abuse, hemodialysis, or vaccinations for hepatitis B, rabies, or influenza..." (Archives of Internal Medicine, August 2000).
The same is true for the confirmatory test the Western Blot. Causes of indeterminate Western Blots include: "lymphoma, multiple sclerosis, injection drug use, liver disease, or autoimmune disorders. Also, there appear to be healthy individuals with antibodies that cross-react...." (ibid).
Pregnancy is consistently listed as a cause of positive test results, even by the test manufacturers." [False positives can be caused by] prior pregnancy, blood transfusions...and other potential nonspecific reactions." (Vironostika HIV Test, 2003).
Inflated Africa Numbers
This is significant in Africa, because HIV estimates for African nations are drawn almost exclusively from testing done on groups of pregnant women.
In Zimbabwe last year, the rate of HIV infection among young women decreased remarkably, from 32.5 to 6 percent. A drop of 81 percent overnight. UNICEF's Swaziland representative, Dr. Alan Brody, told the press that, "The problem is that all the sero-surveillance data came from pregnant women, and estimates for other demographics was based on that." (PLUS News, August, 2004).
Flawed Samples
When these pregnant young women are tested, they're often tested for other illnesses, like syphilis, at the same time. There's no concern for cross-reactivity or false-positives in this group, and no repeat testing. One ELISA on one girl, and 32.5 percent of the population is suddenly HIV positive.
The June 20, 2004 Boston Globe reported "the current estimate of 40 million people living with the AIDS virus worldwide is inflated by 25 percent to 50 percent." It said that HIV estimates for entire countries have, for over a decade, been taken from "blood samples from pregnant women at prenatal clinics."
But numbers about "AIDS deaths, AIDS orphans, numbers of people needing antiretroviral treatment, and the average life expectancy" are all taken from that one test.
I've certainly never seen this in a VH1 ad.
At present there are about six-dozen reasons given in the literature why the tests come up positive. In fact, the medical literature states that there is simply no way of knowing if any HIV test is truly positive or negative:
"[F]alse-positive reactions have been observed with every single HIV-1 protein, recombinant or authentic." (Clinical Chemistry. 37; 1991). "Thus, it may be impossible to relate an antibody response specifically to HIV-1 infection." (Medicine International. 1988).
Ambiguous Results
And even if you believe the reaction is not a false positive, "the test does not indicate whether the person currently harbors the virus." (Science. November, 1999).
The test manufacturers state that after the antibody reaction occurs, the tests have to be "interpreted." There is no strict or clear definition of HIV positive or negative. There's just the antibody reaction. The reaction is colored by an enzyme, and read by a machine called a spectro-photometer.
The machine grades the reactions according to their strength (but not specificity), above and below a cut-off. If you test above the cut-off, you're positive; if you test below it, you're negative. So what determines the all-important cut-off? From The CDC's instructional material: "Establishing the cutoff value to define a positive test result from a negative one is somewhat arbitrary." (CDC, 2003)
PaulKing - 11 May 2005 12:28 GMT Funny how you call EVERYONE who does not agree with your insane views a lier.
I expect in the absence of real facts it is the best you can do.
PaulKing - 11 May 2005 12:30 GMT How can a test which DOES NOT TEST FOR ANYTHING BUT HARMLESS ANTIBODIES be an accurate 'HIV' test?
Even you cannot believe that.
GMCarter - 11 May 2005 14:49 GMT >How can a test which DOES NOT TEST FOR ANYTHING BUT HARMLESS ANTIBODIES be >an accurate 'HIV' test? LOL. Wow. That explains a lot too.
Antibodies, of course, aren't always harmless. Ever hear of autoimmune disease?
Antibodies don't just happen--they're a response the body makes.
To an infection.
Like HIV.
>Even you cannot believe that. Of course I can. But then, I have at least a small understanding of the basics of infectious disease.
Someone who wallows in ignorance and denial, of course, would be expected to remain obdurately stupid.
George M. Carter
David Canzi -- non-mailable - 11 May 2005 16:11 GMT >How can a test which DOES NOT TEST FOR ANYTHING BUT HARMLESS ANTIBODIES be >an accurate 'HIV' test? Syphilis tests detect harmless antibodies too. Where's your point, Oblio?
 Signature David Canzi
PaulKing - 11 May 2005 12:31 GMT
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