Current Trends
Problems Created by Heat-Inactivation of Serum
Specimens Before HIV-1 Antibody Testing
Among laboratories testing for human immunodeficiency virus type 1
(HIV-1) and participating in CDC's Model Performance Evaluation
Program
(1,2), responses from May and September 1988 survey questionnaires
show
that 40 (3.9%) of 1034 and 41 (3.9%) of 1052 respondents,
respectively,
heat-inactivate serum specimens before testing for HIV-1.
Heat-inactivation is an effective means of destroying HIV-1 (3) and
is
used both to prepare therapeutic blood products and to produce
certain
laboratory quality-control testing materials; however, this method
is
not recommended as a routine means of protecting the safety of
laboratory workers exposed to blood and other body fluids while
performing their jobs. Instead, laboratorians are urged to follow
universal precautions recommending that all blood be considered
potentially infective (4,5).
Heat-inactivation of serum specimens before they are screened by
enzyme immunoassay (EIA) for HIV antibody can give false-positive
results (6,7). Thus, laboratories that continue heat-inactivating
serum
are likely to obtain false-positive results with some EIA kits
(6,7).
Heat-inactivation can also interfere with Western blot analysis
(8).
Universal precautions preclude the necessity of selective treatment
such as heat-inactivation for specimens from persons considered to
be
at increased risk for infection with HIV-1, hepatitis B virus, or
other
diseases caused by bloodborne pathogens. Therefore, CDC recommends
that
laboratories emphasize the practice of universal precautions (4,5)
rather than heat-inactivation of serum to prevent occupational
transmission of HIV.
Reported by: Div of Laboratory Systems, Public Health Practice
Program
Office, CDC.
References
Taylor RN, Przybyszewski VA. Summary of the Centers for Disease
Control human immunodeficiency virus (HIV) performance evaluation
surveys for 1985 and 1986. Am J Clin Pathol 1988;89:1-13.
Schalla WO, Hearn TL, Griffin CW, Taylor RN. Role of the Centers
for
Disease Control in monitoring the quality of laboratory testing for
human immunodeficiency virus infection. Clin Microbiol Newsletter
1988;10:156-9.
Martin LS, McDougal JS, Loskoski SL. Disinfection and
inactivation
of the human T lymphotropic virus type
III/lymphadenopathy-associated
virus. J Infect Dis 1985;152:400-3.
4. CDC. Recommendations for prevention of HIV transmission in
health-care settings. MMWR 1987;36(suppl 2S):3S-18S.
CDC. Update: universal precautions for prevention of
transmission of
human immunodeficiency virus, hepatitis B virus, and other
bloodborne
pathogens in health-care settings. MMWR 1988;37:377-82, 387-8.
Evans RP, Shanson DC, Mortimer PP. Clinical evaluation of Abbott
and
Wellcome enzyme linked immunosorbent assays for detection of serum
antibodies to human immunodeficiency virus (HIV). J Clin Pathol
1987;40:552-5.
McBride JH, Howanitz PJ, Rodgerson DO, Miles J, Peter JB.
Influence
of specimen treatment on nonreactive HTLV-III sera. AIDS Res Hum
Retroviruses 1987;3:333-40.
Goldfarb MF. Effect of heat-inactivation on results of HIV
antibody
detection by Western blot assay. Clin Chem 1988;34:1661-2.
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