Abstract

PIP: The World Health Organization (WHO) estimates of AIDS cases in Africa are based on the results of trials using the two main HIV serodiagnostic tests: the ELISA and the Western Blot. Some AIDS specialists believe that these tests are not accurate enough to confirm HIV positivity. In fact, they may be most meaningless in Africa because the widespread ill-health there contributes to false positive reactions. Malnutrition and associated chronic diseases are the key causes of ill-health in Africa. The US Centers for Disease Control and Prevention considers the ELISA to be only a screening test to detect suspicious blood samples and not a confirmatory test. In the US, the Western Blot is used as a confirmatory test. False positives could be avoided if scientists could use a suitable gold standard (i.e., HIV isolation). Yet HIV has yet to be unequivocally isolated. In fact, according to Neville Hodgkinson, the entire HIV story might be a monumental error. In Africa, due to cost considerations, most people are diagnosed with HIV based on the findings of a single test. Yet many supposedly HIV-infected persons may actually be suffering from influenza, malaria, or malnutrition, all of which can produce positive HIV results. During the second half of the 1980s, there was no public acknowledgment of inadequacies in the HIV test. In 1994, a professor of public health at Harvard, scientists at the University of Kinshasa, and the health ministry in Zaire found that a supposed association with leprosy and HIV infection as detected by the ELISA was actually due to false positives. When they retested using the Western Blot and radioimmunoprecipitation analysis, the number of the 57 leprosy patients found to be HIV positive fell from 37-41 to 2 and the number of contacts found to be HIV positive fell from 9-12 to 0. An non-validated test (i.e., ELISA) has technical problems and pitfalls in interpretation and is vulnerable to shipping, climatic and storage conditions, and subject to unmeasured and immeasurable cross-reactivities, and may give false positive results.