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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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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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