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Prospective Studies in a Low Prevalence Population

Nancy L. Dock, PhD; Steven H. Kleinman, MD; Mark A. Rayfield, PhD; Charles A. Schable, MS; Alan E. Williams, PhD; Roger Y. Dodd, PhD

Arch Intern Med. 1991;151(3):525-530.

Abstract
Interpretation of human immunodeficiency virus (HIV) antibody results that are "indeterminate" rather than clearly positive or negative is problematic for the person delivering the result as well as for the individual being tested. To improve counseling messages for these individuals, we evaluated data collected from a well-characterized cohort of 387 blood donors who had been monitored for up to 2 years. We sought to determine if persons with indeterminate Western blot patterns were infected with HIV, and whether information derived from follow-up monitoring would assist in the development of counseling messages for persons on whom no follow-up information was available. Donors were studied by laboratory assays, clinical evaluation, and assessment of risk for HIV. The absence of HIV infection in 97 of 98 donors with indeterminate Western blot patterns was confirmed by clinical follow-up, Western blot assays of sequential samples, and negative gene amplification results. We propose supplemental guidelines to be used as an adjunct to existing interpretive criteria for counseling individuals when they first present with an indeterminate Western blot finding.

(Arch Intern Med. 1991;151:525-530)

Author Affiliations
From the American Red Cross Blood Services, Syracuse (NY) Region (Dr Dock); the American Red Cross Blood Services, Los Angeles (Calif)/Orange Counties Region (Dr Kleinman); the Division of HIV/AIDS, Center For Infectious Diseases, Centers for Disease Control, Atlanta, Ga (Dr Rayfield and Mr Schable); and the American Red Cross/Jerome H. Holland Laboratory for the Biomedical Sciences, Rockville, Md (Drs Williams and Dodd).

Footnotes
Accepted for publication September 12, 1990.

Reprint requests to Research and Development Laboratory, American Red Cross Blood Services, 636 S Warren St, Syracuse, NY 13202 (Dr Dock).

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