Background: As of June 1, 1992, the Food and Drug Administration recommended that all donated blood be screened for antibodies specific to HIV-2. Despite broad serologic surveillance, only two cases of HIV-2 infection had been detected among potential blood and plasma donors since the implementation of the test.
Case report: The identification of a third HIV-2 antibody-positive blood donor is reported. The first-time donor was identified by routine screening procedures as anti-HIV-1/HIV-2-reactive, and that status was confirmed by licensed HIV-1 Western blot. Concurrent whole-virus lysate enzyme immunoassay and Western blot for HIV-2 were strongly positive, but the possibility of HIV-1 cross-reactivity could not be eliminated. The donor was notified, counseled, and deferred from future donation. He subsequently enrolled in a Centers for Disease Control and Prevention-sponsored epidemiologic study of HIV-positive former donors. When it was revealed during the standardized interview that he was a native of an HIV-2-endemic region, follow-up samples were submitted to the Centers for Disease Control and Prevention. Investigational HIV-1 and HIV-2 peptide enzyme immunoassays indicated that this infection was due to HIV-2 only.
Conclusion: Enzyme immunoassays for antibodies to synthetic peptides of HIV-1 and HIV-2 may be useful in differentiating the two viruses in individuals with ambiguous Western blot results and risk factors for HIV-2 infection.