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Journal of Clinical Microbiology, September 2009, p. 2906-2911, Vol. 47, No. 9
0095-1137/09/$08.00+0     doi:10.1128/JCM.00602-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Census and Analysis of Persistent False-Negative Results in Serological Diagnosis of Human Immunodeficiency Virus Type 1 Group O Infections{triangledown}

J.-C. Plantier,1* M. Djemai,1 V. Lemée,1 A. Reggiani,2 M. Leoz,1 L. Burc,2 A. Vessière,3 D. Rousset,3 J.-D. Poveda,4 C. Henquell,5 A. Gautheret-Dejean,6 and F. Barin7

Laboratoire associé au Centre National de Référence du VIH, Centre Hospitalier Universitaire de Rouen & EA2656, Université de Rouen, Rouen, France,1 Unité de Réactovigilance, Département des Vigilances, Direction de l'Evaluation des Dispositifs Médicaux, AFSSAPS, Saint Denis, France,2 Laboratoire de Virologie, Centre Pasteur du Cameroun, Yaoundé, Cameroon,3 Laboratoire Pasteur-Cerba, Cergy-Pontoise, France,4 Laboratoire de Virologie, CHU de Clermont-Ferrand, Clermont-Ferrand, France,5 Service de Virologie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France,6 Centre National de Référence du VIH, Inserm U966, Université François Rabelais et CHU Bretonneau, Tours, France7

Received 25 March 2009/ Returned for modification 6 May 2009/ Accepted 15 July 2009

Human immunodeficiency viruses (HIV) have a high level of genetic diversity. The outlier variants of HIV type 1 (HIV-1) group O are distantly related to HIV-1 group M. Their divergence has an impact on serological diagnosis, with a risk of false-negative results. In this study, we report 20 failure cases, involving patients with primary or chronic infection, in France and Cameroon between 2001 and 2008. Our results indicate that some assays detected group O infection much less efficiently than others. Two major reasons for these false-negative results were identified: the presence or absence of a group O-specific antigen (and the designed sequence) for the detection of antibodies and the greater envelope variability of group O than of group M strains. This study highlights the complexity of screening for these divergent variants and the need to evaluate test performance with a large panel of strains, due to the extensive diversity of group O variants.

* Corresponding author. Mailing address: Laboratoire de Virologie & Laboratoire associé au Centre National de Référence du VIH, Institut de Biologie Clinique, hôpital Charles Nicolle, CHU de Rouen, 1 rue de Germont, 76031 Rouen, France. Phone: 33 2 32 88 14 62. Fax: 33 2 32 88 80 98. E-mail: jean-christophe.plantier{at}univ-rouen.fr

{triangledown} Published ahead of print on 22 July 2009.

Journal of Clinical Microbiology, September 2009, p. 2906-2911, Vol. 47, No. 9
0095-1137/09/$08.00+0     doi:10.1128/JCM.00602-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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