Reduced frequency of blood donors with false-positive HIV-1 and -2 antibody EIA reactivity after elution of low-affinity nonspecific natural antibodies.

BACKGROUND: The detection by EIA of antibodies (Abs) specific to HIV antigens in the serum of blood donors is important for transfusion safety. A small but significant number of donor sera (0.1-0.3%) yield false-positive results in EIA, and these donors must be permanently deferred from the blood donor list, causing operational and public relations problems. STUDY DESIGN AND METHODS: False-positive EIA reactions could be caused by the binding of low-affinity natural polyreactive Abs, which could be eluted by treatment with a chaotropic agent such as thiocyanate (SCN). The effect of the SCN elution on EIA specificity was studied using tetanus toxoid and HIV Abs. RESULTS: SCN elution preferentially reduced the binding of nonspecific Abs. Testing of 235 seronegative samples in HIV-1 and -2 EIA showed that SCN elution reduced the mean and dispersion of OD values obtained. In addition, SCN elution abolished the false-positive reactivity in HIV-1 and -2 EIA of 69 percent (299/435) of the repeatedly reactive specimens tested without impact on the reactivity of HIV-seropositive specimens. CONCLUSION: The SCN elution step increased the specificity of HIV-1 and -2 EIA and could facilitate the re-entry of previously deferred donors.