False-Positive Human Immunodeficiency Virus Type 1 Nucleic Acid Amplification Testing in Chimeric Antigen Receptor T Cell Therapy.

We describe three clinical scenarios in which CAR T- cell immunotherapy interfered with HIV-1 testing including: (1) routine infectious disease screening prior to stem cell transplantation in a 16-year-old female with B-cell acute lymphoblastic leukemia, status post CAR T- cell treatment (2) routine infectious disease screening prior to 2nd CAR T- cell collection in a 65-year-old male with diffuse large B-cell lymphoma who failed initial CAR T- cell treatment and (3) routine infectious risk assessment following an occupational health exposure from a 58 -year-old male with multiple myeloma, status post CAR T- cell treatment. In each case, patients initially tested negative by the fourth generation HIV-1 screening enzyme immunoassay (targeting p24 antigen and anti-HIV-1 antibodies), but positive by the Roche COBAS® AmpliPrep/COBAS® TaqMan® HIV-1-1 Test, v2.0 (targeting gag and LTR). These samples were subsequently retested negative using the Abbott Realtime m2000 HIV-1-1 assay which targets the integrase gene. These results indicated that cross reactions between lentiviral vectors and LTR genomes targeted in the HIV-1-1 NAAT caused the HIV-1 NAAT false positive results. PMID: 31694968 [PubMed - as supplied by publisher]
Source: Clinical Lymphoma and Myeloma - Category: Cancer & Oncology Authors: Tags: J Clin Microbiol Source Type: research