HIV-1 infection in a patient of acute lymphocytic leukaemia missed by HIV-spot and HIV-scan rapid tests

A case of HIV-1 infection, presumably acquired through unsafe blood transfusion in an acute lymphocytic leukemia (ALL) patient, is reported here in whom the two rapid HIV antibody detection kits (HIV-spot and HIV-Scan) failed to diagnose the infection while the sample was strongly positive in microwell ELISA (detect- HIV) on the same day and was confirmed by western blot assay (NEW LAV BLOT-1). However, repeat sample after 15 days was found positive in all the tests. Though the rapid tests are preferred over microwell ELISA because of ease of performance and rapid availability of results, this report confirms low sensitivity of the two rapid tests. This suboptimal sensitivity, particularly in cases of early seroconversion, therefore, must be borne in mind for screening the blood and organ donors under strategy-I.