2005/12/7(수)

말라리아 환자에게 나타난 HIV 위양성   [설명 : 2004년 아프리카의 에티오피아에서 있은 말라리아 환자에 대한 HIV 혈청 검사 결과 말라리아에 걸린 상태에서 검사를 받으면 소위 위양성이 나타난다는 걸 상술한 보고서입니다.  말라리아 환자에게는 엘리자 검사와 웨스턴 블랏 검사 모두 위험하다고 적고 있습니다. 그런데 한국에서는 말라리아 환자에게 어김없이 HIV 혈청 검사를 실시하고 있고, 이들 중에서 많은 수가 HIV 양성 반응을 일으키고 있습니다. 이 굉장히 끔찍한 사실이 더 많은 사람들에게 알려져야 할 것입니다.] 출처 : http://ww2.aegis.org/conferences/iac/2004/B12068.html False-positive HIV serological tests in acute malaria patients in Ethiopia.   Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B12068)   Kassa D, Petros B, Mesele T, Tilahun T, Mekonnen T, Meless H, Wolday D EHNRI, Addis Ababa, Ethiopia   -------------------------------------------------------------------------------- BACKGROUND:   We were assessing the possible association of malaria and HIV infections at Wonji Sugar Estate. METHODS:   Malaria parasites were detected using light Midroscopy. Anti-HIV antibodies were tested using rapid tests, HIV spot and Determine HIV-1/2. Seropositive results were confirmed by ELISA  and Western Blot (WB). RESULTS:   166 malaria patients were included in the study. Out of these 166 plasma samples 107 were tested by Determine HIV-1/2 and 8 (7.5%) were HIV positives while 2 (1.9%) give invalid results. However, out of these 8 seropositives, only 4 were confirmed to be HIV positives by both ELISA and WB, while the remaining 4 were HIV negative by ELISA but indeterminate by WB. Serostatus of the remaining 59 plasma samples were tested by HIV spot, and 3 (5.1%) were seropositives. However, all these three seropositive samples were confirmed to be seropositive by both ELISA and WB. Furthermore, 56 plasma samples, which had been seronegative by HIV spot, were further re-tested by Determine HIV-1/2 and 3 (5.4%) were found to be HIV positives. However, out of these 3 HIV positives, 2 of them were negative by ELISA and indeterminate by WB, but one sample was still positive by both ELISA and WB. Moreover, when 4 plasma samples, which were positive by Determine HIV-1/2, but negative by ELISA and indeterminate by WB were re-tested by Uni-Gold test, three of them were weak HIV positive but one was negative. Furthermore, when we re-test 4 other samples, which were positive by Determine HIV-1/2, but negative by ELISA and indeterminate by WB, by PCR (which detects HIV-1 DNA), all of them were seronegatives. CONCLUSION: While rapid HIV tests Determine HIV-1/2 and Uni-Gold give false positive, HIV spot gives false negatives during acute malaria infections. WB on the other hand gives indeterminate results. Thus, this study suggests Determine HIV-1/2 and Uni-Gold rapid tests should be interpreted with great caution in malaria endemic areas. Moreover, the application of WB as confirmatory test in malaria endemic areas should also be evaluated further.