![]() After unnecessary hospitalization, testing, and consultations, the true etiology of this case was confirmed as CMV by highly positive CMV IgM, low positive CMV IgG, positive CMV polymerase chain reaction (PCR), and negative EBV PCR results. For example, a 39-year-old woman with myalgia, low-grade fever, chills, headache, and polyarthralgia tested positive for both cytomegalovirus (CMV) IgM and Epstein-Barr virus (EBV) viral capsid antigen (VCA) IgM. However, false-positive reactions can occur due to interference by pre-existing antibodies (Abs) against other infectious diseases, leading to a cascade of unnecessary tests and treatments. Keywords: Immunoassay, Viral antibodies, Immunoglobulin M, Immunoglobulin G, Cross-reactivityĬurrent infections are frequently diagnosed based on positive immunoglobulin (Ig) M results. Considering cross-reactivity of Ab assays with other pre-existing infectious Abs, infectious Ab results should be carefully interpreted. Upon supplemental testing, Architect rubella IgM, CMV IgM, and anti-HCV showed reactive or gray zone for two sera with HSV IgM (κ=0.903), eight to fifteen with various Abs (κ=0.607–0.814), and one with HAV IgG (κ=0.960), respectively.Ĭonclusions: Architect rubella IgM, CMV IgM, and anti-HCV showed cross-reactivity with reactive sera to other infectious Abs. Results: Except Elecsys HBc IgM, six assays showed reactive for several sera, including other infectious Abs. Additionally, sera showing repeatedly reactive were evaluated by following supplemental testing: Elecsys Toxo IgM, HIV Duo and HAV IgM, VIDAS rubella IgM and CMV IgM (bioMérieux SA, France) LIAISON XL CMV IgM (DiaSorin S.p.A., Italy) and HCV blot 3.0 (MP Diagnostics Inc., Philippines). All sera were tested with seven assays in duplicate: Architect rubella IgM, CMV IgM, Toxo IgM, HIV Ag/Ab, HAV IgM, anti-HCV (Abbott Laboratories, USA), and Elecsys HBc IgM (Roche Diagnostics GmbH, Germany). Methods: A total of 167 positive sera were collected for: rubella IgM and IgG, cytomegalovirus (CMV) IgM and IgG, Toxoplasma gondii (Toxo) IgG, human immunodeficiency virus (HIV) antigen (Ag)/Ab, hepatitis A virus (HAV) IgM and IgG, hepatitis C virus (HCV) Ab, herpes simplex virus (HSV) IgM and IgG, Epstein-Barr virus viral capsid Ag IgM, hepatitis B core (HBc) IgM, hepatitis B e Ab, and severe acute respiratory syndrome coronavirus 2 total Ab, Treponema pallidum IgM (each n=10) and Toxo IgM (n=7). We evaluated cross-reactivity among infectious antibody (Ab) assays. Background: Current infections are frequently diagnosed based on positive immunoglobulin (Ig) M results, although false positivity can occur.
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