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Insufficiencies of the New WHO Western Blot Criteria in the Diagnosis of HIV‐1 and HIV‐2 Infections

This letter to the editor reports the results of a multicenter study on the prevalence of HIV infections in Spain. In 1990 902 serum samples from high-risk individuals were collected and tested for HIV-1/HIV-2 combined enzyme immunoassay. All repeatedly reactive samples were analyzed in parallel using specific Western blot (WB) assays and in addition all these samples were tested by an enzyme immunodot assay (EIDA) using synthetic peptides from the transmembrane protein of each virus. Results revealed that a total of 12 individuals were positive for HIV-2 using the new WHO-WB criteria: 7 African immigrants from Gambia and Senegal and 5 drug abusers from Barcelona. The 5 drug abusers were also positive for HIV-1 by WB. The EIDA confirmed this dual reactivity in only 2 of them suggesting co-infection and it showed only HIV-1 reactivity in the other 3. The results of the EIDA of the African samples were also discordant compared with the results from the WB assay. In conclusion this study provides evidence that the new WHO criteria for interpreting WB do not appropriately distinguish HIV-1 and HIV-2 infections.