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To the Editor: I endorse the CDC recommendations for opt-out HIV testing discussed in the Special Communication by Dr Bartlett and colleagues¹ and believe that all available tools to identify and counsel HIV-infected individuals should be pursued. However, one important population of persons must be considered in any such policy: those who are participants in HIV vaccine trials. By 2008, more than 30 000 individuals worldwide had participated voluntarily in experimental HIV vaccine trials.^2-3 The CDC recommendations pose some complex issues for these HIV vaccine trial participants, as many will test positive in many of the antibody-based screening assays.⁴ In the last 5 years, almost all HIV vaccines have elicited some reactivity in commercially based assays.⁴ All of these vaccine study participants are HIV-negative by RNA/DNA assays.^{2, 5}

It is not known how long experimental vaccine recipients will retain these antibodies, but antibody-only testing can lead to an incorrect HIV diagnosis and . . . [Full Text of this Article]

Lawrence Corey, MD
lcorey@u.washington.edu
Vaccine and Infectious Disease Institute
Fred Hutchinson Cancer Research Center
Seattle, Washington

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