It is expected that this list will generate much discussion and dissension. For the time being, a few clarifications should be made at the outset.
Just because something is on the 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.
Some things are more likely than others to cause false-positives. And some things that we aren't aware of yet, but which may be documented in the future, may cause false-positives. Some of the factors on the list have been documented only for ELISA, some for both ELISA and Western blot (WB).
Some 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, so everything should be OK. But remember, a WB is positive by virtue of accumulating enough individual positive bands to add up to the total required by whatever criteria you use to interpret it (39) So the more exposures 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 general population don't. However, even people in the low-risk populations may have false-positive Western blots for poorly understood reasons.(47)
Since false-positives to every single HIV protein have been documented (36), how do you know the positive WB bands represent the various proteins to HIV, or just a collection of false-positive bands reacting to several different non-HIV antibodies?
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