False positive IgM serologies associated with recent HIV diagnosis.

Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

False positive IgM serologies associated with recent HIV diagnosis.

Int Conf AIDS. 1994 Aug 7-12;10(2):134 (abstract no. PB0548). Unique Identifier : AIDSLINE ICA10/94371147
Rusnak JM; Blatt SP; Wilford Hall Medical Center, Lackland Air Force Base, TX; 78236-5300.

Abstract: OBJECTIVE: HIV seroconversion may be clinically indistinguishable from mononucleosis syndromes due to toxoplasma (toxo), EBV, and CMV. Following identification of 2 patients during the HIV seroconversion syndrome with a false positive toxo IgM, a false positive RPR (1 patient), and positive EBV and CMV IgM serologies, we reviewed IgM serological testing in the United States Air Force HIV Natural History study cohort. METHODS: Toxo, EBV, CMV serologies, and immunoglobulin levels of 1352 HIV patients obtained yearly from January 1986-89, and 1992 were reviewed (toxo 1986-87, 92 only). RESULTS: TABULAR DATA, SEE ABSTRACT VOLUME. 51-70% of IgM serologies were obtained post diagnosis of HIV. Seven patients with proven false positive toxo IgM's had higher total serum IgM levels than IgM negative patients (340 mg/dl +/- 44 vs 213 mg/dl +/- 16, P = .03) as did patients with positive EB VCA IgM's (203 mg/dl +/- 17 vs 160 mg/dl +/- 3, P = .01). The median HIV seroconversion time of 4 known seroconvertors with (+) toxo IgM's was lower than 121 IgM(-) patients (155 vs 990 days). DISCUSSION AND CONCLUSIONS: Given the prevalence of positive IgM serologies in early HIV infection (particularly near seroconversion) which may represent false positives, relapses, or initial infection, one must be cautious in diagnosing a mono-like illness if there are risk factors for HIV. Nonspecific elevation of total IgM levels may explain this predisposition for false positive IgM serologies.

Keywords: Animal Antibodies, Protozoan/BLOOD Antibodies, Viral/BLOOD AIDS Serodiagnosis Cytomegalovirus/IMMUNOLOGY Cytomegalovirus Infections/DIAGNOSIS/IMMUNOLOGY False Positive Reactions Human HIV Seropositivity/DIAGNOSIS/*IMMUNOLOGY IgG/*BLOOD Infectious Mononucleosis/DIAGNOSIS/IMMUNOLOGY Time Factors Toxoplasma/IMMUNOLOGY Toxoplasmosis/DIAGNOSIS/IMMUNOLOGY ABSTRACT
941230
M94C2238

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