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Purpose <p>This study evaluates COVID-19 pandemic phase-specific variations in HIV seroprevalence among volunteer blood donors to elucidate determinants of assay discordance.</p> Methods <p>This retrospective cohort study analyzed 681,232 volunteer blood donations (Wenzhou, 2017-2023) across four pandemic phases: pre-pandemic, containment, surge (Jan-Feb 2023), and stabilization. All specimens underwent dual HIV serological/nucleic acid screening, with reactive cases referred for CDC confirmation.</p> Results <p>Analysis of 681,232 specimens revealed an overall HIV seroreactivity rate of 0.14%, escalating from 0.08% (pre-pandemic) to 0.91% during the Omicron surge phase (Jan-Feb 2023). Among 184 reactive cases in the surge period, 178 (96.7%) showed single-reagent reactivity with predominantly low S/CO&#xa0;ratios (94.9%&#xa0;&lt;5.0), all Western blot (WB)-negative. Significant variance occurred across gender (P=0.043), age (P=0.007), and donation frequency (P=0.001). Indeterminate WB results (n=37) exhibited 5 immunoblot band patterns, with P24 predominance suggesting assay interference.</p> Conclusion <p>SARS-CoV-2 infection induces HIV false-positive seroreactivity, necessitating algorithm optimization in clinical laboratories during pandemic waves to conserve blood resources.</p>

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Study on the Impact of Cross-Reactive Antibodies Induced by SARS-COV-2 Infection on the False-Positive Rate of HIV Serological Testing

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月6日

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  • Dong Chen,
  • Jiayi Zhang,
  • Feng Zhang,
  • Bi Lin,
  • Jie Yang,
  • Tong Chen,
  • Ledan Chen,
  • Chenwei Zhang,
  • Fan Zhou

摘要

Purpose

This study evaluates COVID-19 pandemic phase-specific variations in HIV seroprevalence among volunteer blood donors to elucidate determinants of assay discordance.

Methods

This retrospective cohort study analyzed 681,232 volunteer blood donations (Wenzhou, 2017-2023) across four pandemic phases: pre-pandemic, containment, surge (Jan-Feb 2023), and stabilization. All specimens underwent dual HIV serological/nucleic acid screening, with reactive cases referred for CDC confirmation.

Results

Analysis of 681,232 specimens revealed an overall HIV seroreactivity rate of 0.14%, escalating from 0.08% (pre-pandemic) to 0.91% during the Omicron surge phase (Jan-Feb 2023). Among 184 reactive cases in the surge period, 178 (96.7%) showed single-reagent reactivity with predominantly low S/CO ratios (94.9% <5.0), all Western blot (WB)-negative. Significant variance occurred across gender (P=0.043), age (P=0.007), and donation frequency (P=0.001). Indeterminate WB results (n=37) exhibited 5 immunoblot band patterns, with P24 predominance suggesting assay interference.

Conclusion

SARS-CoV-2 infection induces HIV false-positive seroreactivity, necessitating algorithm optimization in clinical laboratories during pandemic waves to conserve blood resources.