Human Immunodeficiency Virus Book

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HIV Western Blot

Aka: HIV Western Blot, HIV Confirmatory Test
  1. Indication
    1. Previously used to confirm positive HIV EIA (HIV Screening Test)
    2. Replaced by
      1. HIV-1/HIV2 Discriminatory Assay (Multispot)
      2. HIV-1 RNA Nucleic Acid Amplification Test (NAT or NAAT) for HIV RNA Viral Activity
  2. Mechanism
    1. Direct visualization of antibodies to HIV components
      1. Components: Env, Gag, Pol
      2. Antibodies: p24, gp41, gp120, gp160
      3. Band forms if Antibody present to that component
    2. Positive Test
      1. Two or more bands from p24, gp41, gp120 or qp160
  3. Efficacy
    1. Reliably identifies HIV-1
    2. False negative causes
      1. Group O protein (10% False Negative Rate)
      2. HIV-2 (20% False Negative Rate)
      3. Early seroconversion (less sensitive than HIV ELISA)
    3. False positive causes
      1. Hyperbilirubinemia
      2. Connective tissue disorder
      3. Polyclonal Gammopathy
  4. Follow-Up evaluation for indeterminate or negative test
    1. Repeat Western blot in 1-3 months
    2. Consider Western blot for HIV-2
  5. References
    1. Demeter in Mandell (2000) Infectious Disease, p. 1371

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