False Positive Tests for HTLV-III Antibodies in Alcoholic Patients with Hepatitis

Serum from 95 patients with acute alcoholic hepatitis was analyzed by enzyme immunoassay and (if positive) by Western blot for human T-lymphotropic virus type III (HTLV-III) antibodies. Patients who had a current history of drug abuse or positive tests for hepatitis B virus surface antigen were excluded. Clinically severe liver disease was present in 31 patients moderate disease in 34 and mild disease in 30. Anergy was observed in 60 patients and an adequate delayed cutaneous hypersensitivity response was observed in 34 patients. Although hepatitis B surface antigenemia on admission was a reason for exclusion from the study antibodies to the hepatitis B surface antigen the core antigen or both were observed in 31% of the samples. Of the 95 patients 13% were positive for HTLV-III antibody by the enzyme immunoassay. However all of these samples were negative by the Western blot assessment. The incidence of unconfirmed positive results on the less specific immunoassay observed in these alcoholic patients with hepatitis (13%) stands in contrast to the incidence of 0.89% among blood donors in general. These findings demonstrate that patients with alcoholic liver disease have a high incidence of false positives on tests for HTLV-III antibodies. This is important to recognize so that these patients are not falsely identified as having previous infection with HTLV-III.