Laboratory 2: ELISA Test for HIV-1
 
Symptoms & History

Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation
 

Testing for Acquired Immunodeficiency Syndrome

Laboratory testing for HIV is a two step process. 
  • First is the screening immunoabsorbant assay (ELISA).
    • Now have and oral HIV screening test for saliva. 
  • If the sample is positive, the more specific Western blot is done.
Although the ELISA screening test is pretty reliable (99%), there is a low percentage error rate. 
False Positives
  • Antibody against human tissues (smooth muscle, mitochondria, T-Cells)
  • Anti-Hepatitis A IgM
  • Anti-Hepatitis B core IgM
  • Positive Syphilis serology
  • advanced liver disease
  • Renal failure
  • Cross reacting viruses (HIV-2, HTLV)
  • Passive acquired antibody (transplacenta, immunoglobulin)
  • Malignancy
False Negatives
  • B-Cell dysfunction (severe HIV infection)
  • Hypogammaglogulinemia
  • Test drawn during "window" period
  • Malignancy
  • Immunosuppressive therapy
  • Bone marrow transplant
  • Heat inactivation of antibody in sample while waiting for test to be performed.

Mr. Baldwin's ELISA screening test is positive. But before saying anything, we need to be sure by checking the Western Blot

 

 

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