The potential complexity and need for caution when interpreting atypical human immunodeficiency virus reactivity in blood donors.

2015 
Since the mid-1980s, blood centres worldwide have screened donors for antibodies to human immunodeficiency virus (anti-HIV) and, more recently, many have also implemented screening for HIV by nucleic acid tests (NAT)1,2. Reactivity on anti-HIV screening immunoassays is typically confirmed by immunoblot testing which can, however, generate indeterminate results. In low-risk voluntary blood donors, such indeterminate results usually represent non-specific reactivity3–6. However, this result profile can sometimes occur in HIV-infected individuals undergoing antiretroviral therapy7, and HIV elite controllers who appear to be able to control HIV replication without antiretroviral therapy8,9. In this report we present a case study which highlights the potential complexity and need for caution when interpreting HIV reactivity in blood donors.
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