Because of increased productivity and availability, more people have had the chance to undergo prophylactic influenza vaccination. It has been reported that influenza vaccination has cross-reactivity with human immunodeficiency virus (HIV) antibody assays, but this information is not well known in the field of transplantation. Recently, we experienced a case of living donor liver transplantation in which a healthy donor candidate was frightened and was further screened for the HIV antibody.
The patient was a 43-year-old female who was a candidate for partial liver donation for her husband, who was suffering from hepatocellular carcinoma associated with hepatitis B liver cirrhosis. She had never undergone a blood transfusion or abused drugs before her screening for living partial liver donation. According to her laboratory results, she was positive for the HIV antibody (1.7 cut off index). Otherwise, all data, including hepatitis B antibody results, were within normal limits. It was found that she had undergone vaccination for influenza 1 week before the screening. She was referred to a specialist in HIV infection, and western blotting for all antibodies (GP160, GP110/120, P68/66, P55, P52/51, GP41, P40, P34/31, P24/25, and P18/17) was negative. HIV RNA was undetectable in her blood (<40 copies/mL). Thus, she was considered to be HIV-negative with a high level of confidence and subsequently donated the left lobe of her liver. The recipient remained negative for the HIV antibody even after living donor liver transplantation.
With the prevalence of influenza vaccination and organ donation, physicians should keep in mind that recent inoculation with any brand of influenza vaccine is associated with a false-positive screening assay for HIV antibodies.