Name: Jahnika Blair

I.D number: 620131434

Stream: 1 (B02)

Laboratory 5 (a) Transfusion matching

(b) HIV Testing
________________________________________________________________

There was agglutination seen between Donor B and Donor AB with Recipient Serum #1.
There was agglutination seen between Donor A and Donor AB with Recipient Serum #2. The
B antigen in the recipient serum #1 reacts with/Is compatible with the antibody against B,
anti-B in the donor blood therefore there is agglutination seen in Donor B and Donor AB.
The A antigen in the recipient serum #2 reacts with/Is compatible with the antibody against
A, anti-A in the donor blood therefore there is agglutination seen in donor A and Donor AB.

What is recipient 1’s blood group? recipient 1’s blood group is blood group B.

Which donor(s) can be used for recipient 1? The donor(s) can be used for recipient 1 are:
Blood group O and B

What is recipient 2’s blood group? recipient 2’s blood group is group A

What donor(s) can be used for recipient 2? The donor(s) can be used for recipient 2 are:
Blood group O and A
Exercise: HIV Testing Student Worksheet

You oversee a medical diagnostic laboratory where HIV testing is offered as a service. A
medical doctor has requested serological diagnoses on twelve (12) clients and, where
applicable, follow-up leading to confirmed diagnostic status.

Notes:

Person 1 31 years old male; single; sexually active, multiple partners; not homosexual
Person 2 19 years old male; sexually active, multiple partners; not homosexual;
Person 3 21 years old female; sexually active; single partner
Person 4 18 years old male; multiple partners; bisexual; i.v. drugs; STD (Ng/HSV2)
Person 5 16 years old female; rape victim (5 weeks ago)
Person 6 35 years old female; married; SLE
Person 7 19 years old female; single; single partner; routine
Person 8 11 month old female infant; HIV1+ mother
Person 9 39 years old male; multiple partners, not homosexual
Person 10 23 years old female; single; SLE
Person 11 27 years old male; multiple partners; not homosexual; STD (Ng)
Person 12 27 years old male taking PrEP drugs
What are your findings in each case? Justify your position.

Person 1 is a 31 years old male; single; sexually active, multiple partners; not homosexual.
Person 1 is HIV positive (strong positive) according to ELISA TEST #1 however, when a
follow-up diagnosis was done i.e., ELISA TEST #2 to confirm the diagnostic status of the
patient based on the results Person 1 gave an indeterminate result, a weak positive. Most
people develop detectable antibodies approximately 30 days after infection both tests were
positive for HIV for this person meaning that the window period had passed for the detection
of antibodies to the virus and the person was positive and had measurable antibodies by
serological testing such as the ELISA test to HIV by seroconversion. According to the results
of the western blot there were bands seen at p24 AND bands present at both gp160 and gp120
depicting a positive (low positive) result. The Western blot positive control lane contains
proteins from patient sera as well as HIV proteins. HIV positive status can therefore only be
confirmed by the presence of the following types of proteins, gp160 viral envelope precursor
(env), gp120 viral envelope protein (env) binds to CD4, p24 viral core protein (gag) and p31
reverse transcriptase (pol).

Person 2 is a 19 years old male; sexually active, multiple partners; not homosexual. Person 2
is HIV positive (strong positive) according to ELISA TEST #1 and ELISA TEST #2. Most
people develop detectable antibodies approximately 30 days after infection both tests were
positive for HIV for this person meaning that the window period had passed for the detection
of antibodies to the virus and the person was positive and had measurable antibodies by
serological testing such as the ELISA test to HIV by seroconversion in both tests. According
to the results of the western blot there were bands seen at p24 AND bands present at both
gp160 and gp120 depicting a positive (low positive) result. The Western blot positive control
lane contains proteins from patient sera as well as HIV proteins. HIV positive status can
therefore only be confirmed by the presence of the following types of proteins, gp160 viral
envelope precursor (env), gp120 viral envelope protein (env) binds to CD4, p24 viral core
protein (gag) and p31 reverse transcriptase (pol).

Person 3 is a 21 years old female; sexually active; single partner. Person 3 had an
indeterminate HIV status, a weak positive based on ELISA TEST #1 however, when a
follow-up diagnosis was done i.e., ELISA TEST #2 to confirm the diagnostic status of the
patient based on the results Person 3 is HIV positive (strong positive) according to ELISA
TEST #2. A weak positive (indeterminate result) may occur during the ‘window period’ of
infection. This period involves an interval of three weeks to six months between the time of
HIV infection and the production of measurable antibodies by serological testing such as the
ELISA test to HIV by seroconversion. When ELISA TEST #2 was conducted a strong
positive result was due to there being enough measurable antibodies to HIV by
seroconversion. According to the results of the western blot there were bands seen at p24
AND bands present at both gp160 and gp120 depicting a positive (low positive) result. The
Western blot positive control lane contains proteins from patient sera as well as HIV proteins.
HIV positive status can therefore only be confirmed by the presence of the following types of
proteins, gp160 viral envelope precursor (env), gp120 viral envelope protein (env) binds to
CD4, p24 viral core protein (gag) and p31 reverse transcriptase (pol).
Person 4 is a 18 years old male; multiple partners; bisexual; i.v. drugs; STD (Ng/HSV2).
Person 4 had an indeterminate HIV status, a weak positive based on ELISA TEST #1
however, when a follow-up diagnosis was done i.e., ELISA TEST #2 to confirm the
diagnostic status of the patient based on the results Person 4 is HIV positive (strong positive)
according to ELISA TEST #2. A weak positive (indeterminate result) may occur during the
‘window period’ of infection. This period involves an interval of three weeks to six months
between the time of HIV infection and the production of measurable antibodies by
serological testing such as the ELISA test to HIV by seroconversion. When ELISA TEST #2
was conducted a strong positive result was due to there being enough measurable antibodies
to HIV by seroconversion. According to the results of the western blot there were bands seen
at p24 AND bands present at both gp160 and gp120 depicting a positive (pattern with high
positive result) result. The Western blot positive control lane contains proteins from patient
sera as well as HIV proteins. HIV positive status can therefore only be confirmed by the
presence of the following types of proteins, gp160 viral envelope precursor (env), gp120 viral
envelope protein (env) binds to CD4, p24 viral core protein (gag) and p31 reverse
transcriptase (pol).

Person 5 is a 16 years old female; rape victim (5 weeks ago). Person 5 is HIV negative
(strong negative) according to ELISA TEST #1. The results show that this person is HIV
negative however, there is a possibility that this may be a false negative as the test was
conducted 5 weeks after the person was raped. A false negative result may occur during the
‘window period’ of infection. This period involves an interval of three weeks to six months
between the time of HIV infection and the production of measurable antibodies by
serological testing such as the ELISA test to HIV by seroconversion.

Person 6 is a 35 years old female; married; SLE. Person 6 is HIV positive (strong positive)
according to ELISA TEST #1 however, when a follow-up diagnosis was done i.e., ELISA
TEST #2 to confirm the diagnostic status of the patient based on the results Person 6 gave a
HIV negative result which means that the results of ELISA TEST # 1 was a false positive.
Systemic lupus erythematosus (SLE) is an autoimmune disease, the antibodies s to this
disease are detectable by the ELISA test. False-positive HIV ELISA test is a regular
occurrence in patients with SLE as HIV and SLE have a significant common of clinical and
serologic features (Quiñones et al., 2006). The presence of autoantibodies and as a result of
cross-reactivity in the diagnosis of HIV with systemic autoimmune diseases is a result of this
(Jian et al., 2015). This may have occurred in an episode where there was a flare-up of the
disease resulting in the production of detectable antibodies and after the second test was
conducted the numbers decreased to an undetectable amount.

Person 7 is a 19 years old female; single; single partner; routine. Person 7 is HIV negative
(strong negative) according to ELISA TEST #1 as there were no detectable antibodies to HIV
as this person was not infected.
Person 8 is a 11-month-old female infant; HIV1+ mother. Person 8 had an indeterminate HIV
status, a weak positive based on ELISA TEST #1 however, when a follow-up diagnosis was
done i.e., ELISA TEST #2 to confirm the diagnostic status of the patient based on the results
Person 8 still had a stronger positive result. The HIV virus is transmitted from a mother to her
baby during pregnancy, childbirth or during breastfeeding. The results of the ELISA tests
depict that the person is HIV positive however the amount of antibodies present to the virus
are not at an amount where they would be measured to give a strong positive result. This may
mean that this person was recently infected perhaps through breastfeeding as the mother’s
viral load increased to pass the virus through the breastmilk. According to the results of the
western blot there were faded bands seen at p24 AND bands present at either gp160 depicting
an indeterminate/positive result. If band is present, but the pattern/intensity/presence does not
meet criteria for positivity the result is indeterminate. Tests where less than the required
number/intensity of viral bands are detected are reported as indeterminate. Almost all HIV-
infected persons with indeterminate Western-Blot results will develop a positive result when
tested again in one month. If at least one viral band for each of the GAG with the most
important being the capsid protein: p24, POL the most important being the reverse
transcriptase: p31, and ENV gene-product groups (gp41, 120 or 160) are present, the result is
positive.

Person 9 is a 39 years old male; multiple partners, not homosexual. Person 9 had an
indeterminate HIV status, a moderate positive based on ELISA TEST #1 however, when a
follow-up diagnosis was done i.e., ELISA TEST #2 to confirm the diagnostic status of the
patient based on the results Person 9 had a weaker positive result, an indeterminate result.
Persistently indeterminate results over a period of six months suggests the results may not be
due to HIV infection. The antibodies present to the illness the person is experiencing as cross-
reactivity to the HIV antigens of the test. However, according to the results of the western
blot there were faded bands seen at p24 AND bands present at either gp160 depicting an
indeterminate/positive (low positive) result. If at least one viral band for each of the GAG
with the most important being the capsid protein: p24, POL the most important being the
reverse transcriptase: p31, and ENV gene-product groups (gp41, 120 or 160) are present, the
result is positive.

Person 10 is a 23 years old female; single; SLE. Person 10 HIV positive (strong positive)
according to ELISA TEST # and ELISA TEST #2. Systemic lupus erythematosus (SLE) is an
autoimmune disease, the antibodies s to this disease are detectable by the ELISA test. False-
positive HIV ELISA test is a regular occurrence in patients with SLE as HIV and SLE have a
significant common of clinical and serologic features (Quiñones et al., 2006).The presence of
autoantibodies and as a result of cross-reactivity in the diagnosis of HIV with systemic
autoimmune diseases is a result of this (Jian et al., 2015). However, most people develop
detectable antibodies approximately 30 days after infection both tests were positive for HIV
for this person meaning that the window period had passed for the detection of antibodies to
the virus and the person was positive and had measurable antibodies by serological testing
such as the ELISA test to HIV by seroconversion in both tests. According to the results of the
western blot there were faded bands seen at p24 depicting an indeterminate/positive result. If
band is present, but the pattern/intensity/presence does not meet criteria for positivity the
result is indeterminate. Tests where less than the required number/intensity of viral bands are
detected are reported as indeterminate. Almost all HIV-infected persons with indeterminate
Western-Blot results will develop a positive result when tested again in one month. If at least
one viral band for each of the GAG with the most important being the capsid protein: p24,
POL the most important being the reverse transcriptase: p31, and ENV gene-product groups
(gp41, 120 or 160) are present, the result is positive.

Person 11 is HIV positive (strong positive) according to ELISA TEST #1 however, when a
follow-up diagnosis was done i.e., ELISA TEST #2 to confirm the diagnostic status of the
patient based on the results Person 11 gave an indeterminate result, a weak positive.
According to the results of the western blot there were bands seen at p24 AND bands present
at both gp160 depicting a positive (pattern with high positive result) result. The Western blot
positive control lane contains proteins from patient sera as well as HIV proteins. HIV positive
status can therefore only be confirmed by the presence of the following types of proteins,
gp160 viral envelope precursor (env), gp120 viral envelope protein (env) binds to CD4, p24
viral core protein (gag) and p31 reverse transcriptase (pol).

Person 12 is a 27 years old male taking PrEP drugs. Pre-exposure prophylaxis, or PrEP is a
drug taken daily by persons who are at substantial risk of getting it to prevent HIV infection.
The drug contains two medicines (tenofovir and emtricitabine) that are used in combination
with other medicines to treat HIV. Person 12 is HIV negative (strong negative) according to
ELISA TEST #1. HIV tests may false negative results for several months in people taking
PrEP* drugs to avoid getting the virus. Research shows that standard HIV tests may not
detect a new infection until around five months later if a person is using PrEP.
References:

Laboratory 5: (a) Transfusion Matching (b) HIV Testing. (2023). In ZOOL3406: Immunology
Laboratory Manual - (pp. 36-44). Department of Life Sciences Faculty of Pure and
Applied Sciences The University of the West Indies.
Jian, L., Liang, W., Zhang, Y., & Sun, L. (2015). Systemic lupus erythematosus patient with
false positive results of antibody to HIV: A case report and a... ResearchGate; IOS
Press.
https://www.researchgate.net/publication/277978938_Systemic_lupus_erythematosus
_patient_with_false_positive_results_of_antibody_to_HIV_A_case_report_and_a_co
mprehensive_literature_review
‌
Quiñones-Álvarez MSJ, Álvarez-Hernández E, González-Chávez A, et al. False-positive
human immunodeficiency virus testing in a patient with systemic lupus
erythematosus. Rev Med Hosp Gen Mex. 2006;69(4):216-220.