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In Reply. —
From the point of view of the clinical epidemiologist, Dr Isaacman is correct that our patients did not have true-positive HIV test results in the absence of documented infection. Viral cultures were not performed on blood samples from the infant, but p24 antigen assays subsequently carried out on all serum samples had negative results. From the point of view of the clinician involved in patient care, all patients with positive results of enzyme immunoassay followed by a positive Western blot for HIV-specific antibodies are considered to be actively infected in the absence of clinical or epidemiologic information to the contrary. Our serum samples met the criteria for probable HIV infection on that basis, particularly because both mothers were in high-risk groups for HIV infection. Therefore, we trust that Dr Isaacman understands from his own practice that until the specific details of the events described in our article
Schlech WF. Positive HIV Antibody Test Results After Treatment With Hepatitis B Immune Globulin-Reply. JAMA. 1989;262(2):209. doi:10.1001/jama.1989.03430020051021